{"hospital_name": "Southern Inyo Healthcare District", "last_updated_on": "2026-07-28", "version": "3.0.0", "pid": "3319044836", "rid": "15317", "location_name": ["Southern Inyo Hospital"], "hospital_address": ["501 E Locust St, Lone Pine, CA 93545"], "type_2_npi": ["1831128602"], "license_information": {"license_number": "240000205", "state": "CA"}, "attestation": {"attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.", "confirm_attestation": true, "attester_name": "John Tremble"}, "standard_charge_information": [{"description": "\"\"Y SET\"\" TUBING", "code_information": [{"code": "A4719", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 ADMN RSV MONOC ANTB IM NJX", "code_information": [{"code": "96381", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 BOD TEMP >=35.5", "code_information": [{"code": "G9773", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 BODYTEMP >=35.5CW/IN 30MIN", "code_information": [{"code": "4559F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4206", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 EM CORE SESSION", "code_information": [{"code": "G9873", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 MED VISIT IN 24MO", "code_information": [{"code": "G9247", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1 OR NO CT SINUS W/IN 90D DX", "code_information": [{"code": "G9354", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "100 INSULIN SYRINGES", "code_information": [{"code": "S8490", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "12-LEAD ECG PERFORMED", "code_information": [{"code": "3120F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1DOSE MENIG VAC BTWN 11 & 13", "code_information": [{"code": "G9414", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS HIGH 75", "code_information": [{"code": "99223", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST HOSP IP/OBS SF/LOW 40", "code_information": [{"code": "99221", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE HIGH MDM 50", "code_information": [{"code": "99306", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE MODERATE MDM 35", "code_information": [{"code": "99305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST NF CARE SF/LOW MDM 25", "code_information": [{"code": "99304", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST PLMT DRUG ELUT OC INS", "code_information": [{"code": "444T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST PSYC COLLAB CARE MGMT", "code_information": [{"code": "99492", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "1ST/SBSQ PSYC COLLAB CARE", "code_information": [{"code": "99494", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4207", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 10-12 NO WL", "code_information": [{"code": "G9877", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 10-12 WL", "code_information": [{"code": "G9879", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 7-9 NO WL", "code_information": [{"code": "G9876", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM CORE MS MO 7-9 WL", "code_information": [{"code": "G9878", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 13-15 WL", "code_information": [{"code": "G9882", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 16-18 WL", "code_information": [{"code": "G9883", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 19-21 WL", "code_information": [{"code": "G9884", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2 EM ONGOING MS MO 22-24 WL", "code_information": [{"code": "G9885", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ ANTI-HYPRTNSV AGENTS TKN", "code_information": [{"code": "4145F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ ANTIPSY SCHIZ", "code_information": [{"code": "G0032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2+ BENZO SEIZ", "code_information": [{"code": "G0033", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "20+ CC SYRINGE ONLY", "code_information": [{"code": "A4213", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2019-NCOV DIAGNOSTIC P", "code_information": [{"code": "U0001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D CEPHAL RADIO IMAGE", "code_information": [{"code": "D0702", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D CEPHALOMETRIC IMAGE", "code_information": [{"code": "D0340", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D ORAL/FACIAL PHOTO IMAGE", "code_information": [{"code": "D0703", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TEE W OR W/O FOL W/CON,IN", "code_information": [{"code": "C8925", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,CO", "code_information": [{"code": "C8923", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2D TTE W OR W/O FOL W/CON,FU", "code_information": [{"code": "C8924", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "2VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3 CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4208", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3 COMP FOOT EXAM COMPLETED", "code_information": [{"code": "G9226", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3-D RADIOTHERAPY PLAN", "code_information": [{"code": "77295", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D DENTAL SCAN DIRECT", "code_information": [{"code": "D0801", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D DENTAL SCAN INDIRECT", "code_information": [{"code": "D0802", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D ECHO IMG CGEN CAR ANOMAL", "code_information": [{"code": "93319", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D FACIAL SCAN DIRECT", "code_information": [{"code": "D0803", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D FACIAL SCAN INDIRECT", "code_information": [{"code": "D0804", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D PRINT OF 3D SURFACE SCAN", "code_information": [{"code": "D0396", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76376", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D RENDER W/INTRP POSTPROCES", "code_information": [{"code": "76377", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D VOL IMG&RCNSTJ BRST/AX", "code_information": [{"code": "694T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation", "code_information": [{"code": "944T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy", "code_information": [{"code": "G0566", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3D-CRT/IMRT RECEIVED", "code_information": [{"code": "4165F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "3d anatomical segmentation imaging for preoperative planning, data preparation and transmission, obtained from previous diagnostic computed tomographic or magnetic resonance examination of the same anatomy", "code_information": [{"code": "C8001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4 EM CORE SESSIONS", "code_information": [{"code": "G9874", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "40-75Y W/TYPE 1/2 W/LDL-C RS", "code_information": [{"code": "G9676", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "4VHPV VACCINE 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE AND 0.45% SALINE", "code_information": [{"code": "S5010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE IN LAC RINGERS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7121", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE WITH POTASSIUM", "code_information": [{"code": "S5012", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/NORMAL SALINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7042", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% DEXTROSE/WATER", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7060", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5% WL MAINTND FROM BSLINE WT", "code_information": [{"code": "G9888", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5%DEXTROSE/0.45%SALINE1000ML", "code_information": [{"code": "S5013", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "5+ CC STERILE SYRINGE&NEEDLE", "code_information": [{"code": "A4209", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "7 FLD RTA PHOTO EVC RTNOPTHY", "code_information": [{"code": "2024F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "7 FLD RTA PHOTO W/O RTNOPTHY", "code_information": [{"code": "2025F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "9 EM CORE SESSIONS", "code_information": [{"code": "G9875", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "<50% TOTAL PT OUTPT RA ENCTS", "code_information": [{"code": "M1008", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "<6YR NEW ONSET HD ACHE", "code_information": [{"code": "G2193", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">55 YRS TEMP HD ACHE", "code_information": [{"code": "G2192", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">= 2 SAME HI-RSK MED NOT ORD", "code_information": [{"code": "G9368", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">= 2 SAME HI-RSK MED ORD", "code_information": [{"code": "G9367", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=2 SAME HI-RSK MED W/O DIAG", "code_information": [{"code": "M1209", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=2 SAME MEDS TBL4 NOT ORD", "code_information": [{"code": "M1210", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=50% TOTAL PT OUTPT RA ENCT", "code_information": [{"code": "M1007", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": ">=86Y NO HX COLO CA/RSN SCOP", "code_information": [{"code": "G9659", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified", "code_information": [{"code": "M1379", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D HALFWAY HOUSE, PER DIEM", "code_information": [{"code": "H2034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D TX PROGRAM, PER DIEM", "code_information": [{"code": "H2036", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "A/D TX PROGRAM, PER HOUR", "code_information": [{"code": "H2035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AAC NON-ELECTRONIC BOARD", "code_information": [{"code": "E1902", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0129", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABCIXIMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0130", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD IMAG W/US, CT OR MRI", "code_information": [{"code": "G9455", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABD PARACENTESIS", "code_information": [{"code": "49082", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABL1 GENE", "code_information": [{"code": "81170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD", "code_information": [{"code": "33254", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ADD-ON", "code_information": [{"code": "33257", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA LMTD ENDO", "code_information": [{"code": "33265", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS ADD-ON", "code_information": [{"code": "33259", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/BYPASS EXTEN", "code_information": [{"code": "33256", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA W/O BYPASS EXT", "code_information": [{"code": "33255", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ADD-ON", "code_information": [{"code": "33258", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE ATRIA X10SV ENDO", "code_information": [{"code": "33266", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20982", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE BONE TUMOR(S) PERQ", "code_information": [{"code": "20983", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33250", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33251", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "33261", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE HEART DYSRHYTHM FOCUS", "code_information": [{"code": "93650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUBMUC", "code_information": [{"code": "30802", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE INF TURBINATE SUPERF", "code_information": [{"code": "30801", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ CRYBL", "code_information": [{"code": "32994", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLATE PULM TUMOR PERQ RF", "code_information": [{"code": "32998", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ B9 THYR NDUL PERQ LASR", "code_information": [{"code": "673T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL BRST TUM PERQ CRTX", "code_information": [{"code": "581T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 MAG FLD NDCT", "code_information": [{"code": "739T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ MAL PRST8 TISS HIFU", "code_information": [{"code": "55880", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC LXTR/PERPH NRV", "code_information": [{"code": "441T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC PLEX/TRNCL NRV", "code_information": [{"code": "442T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABLTJ PERC UXTR/PERPH NRV", "code_information": [{"code": "440T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP ABO 7 EXONS", "code_information": [{"code": "180U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO GNOTYP NEXT GNRJ SEQ ABO", "code_information": [{"code": "221U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABO RH BLOOD TYPING DOCD", "code_information": [{"code": "3293F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABOBOTULINUMTOXINA", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0586", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59840", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59841", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59850", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59851", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59852", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59855", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59856", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION", "code_information": [{"code": "59857", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION (MPR)", "code_information": [{"code": "59866", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY", "code_information": [{"code": "770", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABORTION WITHOUT D&C", "code_information": [{"code": "779", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABOVE KNEE SURGICAL STOCKING", "code_information": [{"code": "A4490", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESION SINGLE", "code_information": [{"code": "15786", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABRASION LESIONS ADD-ON", "code_information": [{"code": "15787", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSCESS DRAINAGE UNDER X-RAY", "code_information": [{"code": "75989", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG <= 16 SUC PUMP", "code_information": [{"code": "K0744", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >16<=48 SUC PUMP", "code_information": [{"code": "K0745", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORP DRG >48 SUC PUMP", "code_information": [{"code": "K0746", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABSORPT DRG > 48 SQ IN W/BDR", "code_information": [{"code": "A6256", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT CROWN PORC TO TITANIUM", "code_information": [{"code": "D6097", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT RETAIN PORC TO TITANIUM", "code_information": [{"code": "D6195", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT SUPPORT CROWN TITANIUM", "code_information": [{"code": "D6094", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUT SUPPORT RETAINER TITANI", "code_information": [{"code": "D6194", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED CROWN", "code_information": [{"code": "D6058", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6059", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6060", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6061", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6062", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6063", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED MTL CROWN", "code_information": [{"code": "D6064", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6068", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6069", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6070", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6071", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6072", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6073", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABUTMENT SUPPORTED RETAINER", "code_information": [{"code": "D6074", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABX PRES W/IN 10 DYS OF SYMP", "code_information": [{"code": "G9505", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ABX REG PRESCRIBED", "code_information": [{"code": "G9498", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AC5 WOUND SYSTEM", "code_information": [{"code": "A2020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACAPatch, per square centimeter", "code_information": [{"code": "Q4325", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS OF TRANSEP CYTOL SAMP", "code_information": [{"code": "D0486", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS THORACIC LYMPH DUCT", "code_information": [{"code": "38794", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACCESS/RETORQ IMPLANT SCREW", "code_information": [{"code": "D6089", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE ARB ARNI", "code_information": [{"code": "G2092", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE-I/ARB RX", "code_information": [{"code": "M1200", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB NOT RX'D; DOC REAS", "code_information": [{"code": "G8474", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THERAPY RXD/TAKEN", "code_information": [{"code": "4010F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY FOR MOS/>", "code_information": [{"code": "4210F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY NOT RX'D", "code_information": [{"code": "G8475", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACE/ARB THXPY RX'D", "code_information": [{"code": "G8473", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACELLULAR DERM MATRIX IMPLT", "code_information": [{"code": "15777", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO DL, PER SQ CM", "code_information": [{"code": "Q4293", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACESSO TL, PER SQ CM", "code_information": [{"code": "Q4300", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETATE CONC SOL PER GALLON", "code_information": [{"code": "A4708", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETAZOLAMID SODIUM INJECTIO", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1120", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETONE ASSAY", "code_information": [{"code": "82010", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLINESTERASE ASSAY", "code_information": [{"code": "82013", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BLCKG ANTB", "code_information": [{"code": "86042", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR BNDNG ANTB", "code_information": [{"code": "86041", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCHOLN RCPTR MODLG ANTB", "code_information": [{"code": "86043", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7604", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0132", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACETYLCYSTEINE NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7608", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACID CONC SOL PER GALLON", "code_information": [{"code": "A4709", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACID PERFUSION OF ESOPHAGUS", "code_information": [{"code": "91030", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC IMMITANCE TESTING", "code_information": [{"code": "92570", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACOUSTIC REFL THRESHOLD TST", "code_information": [{"code": "92568", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACP DISCUSS-NO DSCNMKR DOCD", "code_information": [{"code": "1124F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACP DISCUSS/DSCN MKR DOCD", "code_information": [{"code": "1123F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80402", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTH STIMULATION PANEL", "code_information": [{"code": "80406", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIGRAPHY TESTING", "code_information": [{"code": "95803", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIN ANTIBODY EACH", "code_information": [{"code": "86015", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATE MATRIX, PER SQ CM", "code_information": [{"code": "Q4301", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVATED CARBON FILTER, EA", "code_information": [{"code": "A4680", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACTIVITY THERAPY, PER 15 MIN", "code_information": [{"code": "H2032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/O STIMUL 15 MIN", "code_information": [{"code": "97810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/O STIMUL ADDL 15M", "code_information": [{"code": "97811", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/STIMUL 15 MIN", "code_information": [{"code": "97813", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUPUNCT W/STIMUL ADDL 15M", "code_information": [{"code": "97814", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION", "code_information": [{"code": "880", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH CC", "code_information": [{"code": "289", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC", "code_information": [{"code": "288", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC", "code_information": [{"code": "290", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE CHRONIC OBSTRUCT", "code_information": [{"code": "G9681", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE CONGESTIVE HEART", "code_information": [{"code": "G9680", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE PNEUMONIA", "code_information": [{"code": "G9679", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE SKIN INFECTION", "code_information": [{"code": "G9682", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE CARE URINARY TRACT INF", "code_information": [{"code": "G9684", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE FLUID/ELECTRO DISORDER", "code_information": [{"code": "G9683", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE GI BLOOD LOSS IMAGING", "code_information": [{"code": "78278", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH CC", "code_information": [{"code": "835", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH MCC", "code_information": [{"code": "834", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH OTHER PROCEDURES", "code_information": [{"code": "850", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITHOUT CC/MCC", "code_information": [{"code": "836", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MAJOR EYE INFECTIONS WITH CC/MCC", "code_information": [{"code": "121", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC", "code_information": [{"code": "122", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC", "code_information": [{"code": "281", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC", "code_information": [{"code": "280", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC", "code_information": [{"code": "282", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC", "code_information": [{"code": "284", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC", "code_information": [{"code": "283", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC", "code_information": [{"code": "285", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE NURSING FACILITY CARE", "code_information": [{"code": "G9685", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE PVD", "code_information": [{"code": "M1337", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VENOUS THROMBUS IMAGE", "code_information": [{"code": "78456", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACUTE VITREOUS HEMORRHAGE", "code_information": [{"code": "M1333", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYCLOVIR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0133", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUAL", "code_information": [{"code": "82016", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ACYLCARNITINES QUANT", "code_information": [{"code": "82017", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT BEHAVIOR TX PHYS/QHP", "code_information": [{"code": "97155", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT BHV TX EA 15 MIN", "code_information": [{"code": "373T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPT/EXT, PACING/NEURO LEAD", "code_information": [{"code": "C1883", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADAPTIVE BEHAVIOR TX BY TECH", "code_information": [{"code": "97153", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD 30 MINS COUNSEL", "code_information": [{"code": "G2080", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD CLASP TO PARTIAL DENTURE", "code_information": [{"code": "D5660", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD METAL SUB TO ACRYLC DENT", "code_information": [{"code": "D5876", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD PROC CONSTRUCT NEW CROWN", "code_information": [{"code": "D2971", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD TO SPINAL ORTHOSIS NOS", "code_information": [{"code": "L0999", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADD TOOTH TO PARTIAL DENTURE", "code_information": [{"code": "D5650", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITION OF WALKER TO CAST", "code_information": [{"code": "29440", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDITIVE FOR ENTERAL FORMULA", "code_information": [{"code": "B4104", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADDL SUPL MATRL&STAF TM PHE", "code_information": [{"code": "99072", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOMA DETECTED SCREENING", "code_information": [{"code": "3775F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOMA NOT DETECT SCREENING", "code_information": [{"code": "3776F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOSINE INJ 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0153", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IA", "code_information": [{"code": "87301", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS AG IF", "code_information": [{"code": "87260", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ANTIBODY", "code_information": [{"code": "86603", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS ASSAY W/OPTIC", "code_information": [{"code": "87809", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 4", "code_information": [{"code": "90476", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADENOVIRUS VACCINE TYPE 7", "code_information": [{"code": "90477", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHERE TX ASSESS AT LST ANN", "code_information": [{"code": "G8851", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIOLYSIS TUBE OVARY", "code_information": [{"code": "58740", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESION BARRIER", "code_information": [{"code": "C1765", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADHESIVE BANDAGE, FIRST-AID", "code_information": [{"code": "A6413", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADIT MDD DYS REM 12 MNTHS", "code_information": [{"code": "G9509", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJ TSU TRF SCLP ARM <10S", "code_information": [{"code": "14020", "type": "CPT"}, {"code": "4012021", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"minimum": 1590.0, "maximum": 2970.0, "gross_charge": 3000.0, "discounted_cash": 3000.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 1590.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 2970.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 2700.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 2673.0, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 2550.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 1590.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 2550.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 1590.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ADJMT/REVJ EXT FIXJ SYS ANES", "code_information": [{"code": "20693", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUNCTIVE PROCEDURE", "code_information": [{"code": "D9999", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUST MAX PROST APPLIANCE", "code_information": [{"code": "D5992", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUST SLEEP APNEA APPLIANCE", "code_information": [{"code": "D9948", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTABLE CHAIR FOR ESRD PT", "code_information": [{"code": "E1570", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJUSTMENT GASTRIC BAND", "code_information": [{"code": "S2083", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV HRMNL THXPY RXD", "code_information": [{"code": "4164F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV THXPYRXD/RCVD COLON CA", "code_information": [{"code": "4180F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADJV TRTMT CHEMO HER2", "code_information": [{"code": "G2206", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADL PT MJ DEP DS NO RS 12 MO", "code_information": [{"code": "M1020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADL PT MJ DEP DS RS 12 PHQ<5", "code_information": [{"code": "M1019", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADLT DISP UND/PULL ON ABV XL", "code_information": [{"code": "T4544", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV CHEMO 1ST HOME VISIT", "code_information": [{"code": "G0090", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV DRUG 1ST HOME VISIT", "code_information": [{"code": "G0088", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM IV INFUSION DRUG IN HOME", "code_information": [{"code": "G0068", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM OF CHEMO DRUG IN HOME", "code_information": [{"code": "G0070", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM OF SOC DTR ASSESS 5-15 M", "code_information": [{"code": "G0136", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM SQ INFUSION DRUG IN HOME", "code_information": [{"code": "G0069", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM SUBQ DRUG 1ST HOME VISIT", "code_information": [{"code": "G0089", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 1ST", "code_information": [{"code": "M0249", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADM TOCILIZU COVID-19 2ND", "code_information": [{"code": "M0250", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN ECG CONTRAST AGENT", "code_information": [{"code": "93352", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN HEPATITIS B VACCINE", "code_information": [{"code": "G0010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN HOME SLEEP APNEA TEST", "code_information": [{"code": "D9956", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN INFLUENZA VIRUS VAC", "code_information": [{"code": "G0008", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIN PNEUMOCOCCAL VACCINE", "code_information": [{"code": "G0009", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMISSION TO MCCM", "code_information": [{"code": "G9480", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIT W/IN 180D REQ REMOV", "code_information": [{"code": "G9410", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMIT W/IN 180D REQ SURG REV", "code_information": [{"code": "G9412", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMN RSV MONOC ANTB IM CNSL", "code_information": [{"code": "96380", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADMN SARSCOV2 VACC 1 DOSE", "code_information": [{"code": "90480", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADOPTIVE IMMUNOTHERAPY", "code_information": [{"code": "S2107", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADR DEP THRPY PRESCRIBED", "code_information": [{"code": "G9894", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRC THER PRTL RC TEAR", "code_information": [{"code": "717T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRC THER PRTL RC TEAR NJX", "code_information": [{"code": "718T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC", "code_information": [{"code": "614", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC", "code_information": [{"code": "615", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL CORTEX & MEDULLA IMG", "code_information": [{"code": "78075", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRENAL TISSUE TRANSPLANT", "code_information": [{"code": "S2103", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADRNL CORTCL TUM BCHM ASY 25", "code_information": [{"code": "15M", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT 180 DYS PHARMTHRY OUD", "code_information": [{"code": "M1034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT NO 180 DYS PHARMTHRY OUD", "code_information": [{"code": "M1036", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT PD OUT MAT PR 180 DYS TX", "code_information": [{"code": "M1035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADT TKNG PHARMTHRY FOR OUD", "code_information": [{"code": "M1032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT COMPANIONCARE PER 15M", "code_information": [{"code": "S5135", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT COMPANIONCARE PER DIEM", "code_information": [{"code": "S5136", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAY CARE PER DIEM", "code_information": [{"code": "S5102", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAY CARE PER HALF DAY", "code_information": [{"code": "S5101", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DAYCARE SERVICES 15MIN", "code_information": [{"code": "S5100", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT DISP BRIEF/DIAP ABV XL", "code_information": [{"code": "T4543", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT FOSTER CARE PER DIEM", "code_information": [{"code": "S5140", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT FOSTER CARE PER MONTH", "code_information": [{"code": "S5141", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER LG", "code_information": [{"code": "T4523", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER MED", "code_information": [{"code": "T4522", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER SM", "code_information": [{"code": "T4521", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE BRIEF/DIAPER XL", "code_information": [{"code": "T4524", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON LG", "code_information": [{"code": "T4527", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON MED", "code_information": [{"code": "T4526", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON SM", "code_information": [{"code": "T4525", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SIZE PULL-ON XL", "code_information": [{"code": "T4528", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADULT SPEECH AID", "code_information": [{"code": "D5953", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV CARE HEART DX MVP", "code_information": [{"code": "G0055", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV DEM CRGVR LIMITED", "code_information": [{"code": "G9917", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADV RHEUM PT CARE MVP", "code_information": [{"code": "G0053", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVANCED LIFE SUPPORT MILEAG", "code_information": [{"code": "A0390", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVANCING CANCER CARE MVP", "code_information": [{"code": "M0001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNC CARE PLAN IN RCRD", "code_information": [{"code": "1157F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNC CARE PLAN TLK DOCD", "code_information": [{"code": "1158F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNCD CARE PLAN 30 MIN", "code_information": [{"code": "99497", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ADVNCD CARE PLAN ADDL 30 MIN", "code_information": [{"code": "99498", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP HEARING STATUS DETER I&R", "code_information": [{"code": "92651", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP NEURODIAGNOSTIC I&R", "code_information": [{"code": "92653", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP SCR AUDITORY POTENTIAL", "code_information": [{"code": "92650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEP THRSHLD EST MLT FREQ I&R", "code_information": [{"code": "92652", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AEROSOL INHALATION TREATMENT", "code_information": [{"code": "94642", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFAMELANOTIDE IMPLANT, 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7352", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALY DETC ABNL ALLEL", "code_information": [{"code": "81171", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFF2 GEN ALYS CHARAC ALLELES", "code_information": [{"code": "81172", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFFINITY1 SQUARE CM", "code_information": [{"code": "Q4159", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLIBERCEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0178", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFLURIA VACC, 3 YRS & >, IM", "code_information": [{"code": "Q2035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTER CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE WITH CC/MCC", "code_information": [{"code": "949", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE WITHOUT CC/MCC", "code_information": [{"code": "950", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC", "code_information": [{"code": "560", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC", "code_information": [{"code": "559", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC", "code_information": [{"code": "561", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AG DETECTION POLYVAL IF", "code_information": [{"code": "87300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGALSIDASE BETA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0180", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGENT NOS ASSAY W/OPTIC", "code_information": [{"code": "87899", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGGLUTININS FEBRILE ANTIGEN", "code_information": [{"code": "86000", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AGRIFLU VACCINE", "code_information": [{"code": "Q2034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AHI OR RDI INITIAL DX", "code_information": [{"code": "G8842", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI DS SLE ALYS 8 IGG AUTOANT", "code_information": [{"code": "312U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI IBD MRNA XPRSN PRFL 17", "code_information": [{"code": "203U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI PSOR MRNA 50-100 GEN ALG", "code_information": [{"code": "258U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AI SLE IGG&IGM ALYS 80 BMRK", "code_information": [{"code": "62U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AICD GENERATOR PROCEDURES", "code_information": [{"code": "245", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AICD LEAD PROCEDURES", "code_information": [{"code": "265", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AICD, DUAL CHAMBER", "code_information": [{"code": "C1721", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AICD, OTHER THAN SING/DUAL", "code_information": [{"code": "C1882", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AICD, SINGLE CHAMBER", "code_information": [{"code": "C1722", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIR AMBULAN NONEMERG ROTARY", "code_information": [{"code": "S9961", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIR AMBULANC NONEMERG FIXED", "code_information": [{"code": "S9960", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIR ELEVATOR FOR HEEL", "code_information": [{"code": "E0370", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIR INJECTION INTO ABDOMEN", "code_information": [{"code": "49400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIRWAY INHALATION TREATMENT", "code_information": [{"code": "94640", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AIRWY RESIST BY OSCILLOMETRY", "code_information": [{"code": "94728", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BR CA STG I: T1 MIC/T1A", "code_information": [{"code": "G9704", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BR CA STG IB", "code_information": [{"code": "G9705", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRST CNCR STAGE 0 DOCD", "code_information": [{"code": "3370F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRST CNCR STAGE 1 DOCD", "code_information": [{"code": "3372F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRST CNCR STAGE 1 DOCD", "code_information": [{"code": "3374F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRSTCNCR STAGE 2 DOCD", "code_information": [{"code": "3376F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRSTCNCR STAGE 3 DOCD", "code_information": [{"code": "3378F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC BRSTCNCR STAGE 4 DOCD", "code_information": [{"code": "3380F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CLN CNCR STAGE 0 DOCD", "code_information": [{"code": "3382F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CLN CNCR STAGE 1 DOCD", "code_information": [{"code": "3384F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CLN CNCR STAGE 2 DOCD", "code_information": [{"code": "3386F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CLN CNCR STAGE 3 DOCD", "code_information": [{"code": "3388F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CLN CNCR STAGE 4 DOCD", "code_information": [{"code": "3390F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC CNCR 0/IA MELAN DOCD", "code_information": [{"code": "3321F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC MEL CNR STG 0 - IIC", "code_information": [{"code": "G8944", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC STAGE DOCD B/4 THXPY", "code_information": [{"code": "3300F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AJCC STG BRT CA DX II OR III", "code_information": [{"code": "G9831", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AK/FT POWER ASST INCL MOTORS", "code_information": [{"code": "L5969", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALANINE AMINO (ALT) (SGPT)", "code_information": [{"code": "84460", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALARM SYMP ASSESSED-1+ PRSNT", "code_information": [{"code": "1071F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALARM SYMP ASSESSED-ABSENT", "code_information": [{"code": "1070F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALATROFLOXACIN MESYLATE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0200", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUMIN (HUMAN), 25%, 20 ML", "code_information": [{"code": "P9046", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUMIN (HUMAN), 25%, 50ML", "code_information": [{"code": "P9047", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUMIN (HUMAN), 5%, 250 ML", "code_information": [{"code": "P9045", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUMIN (HUMAN),5%, 50ML", "code_information": [{"code": "P9041", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUMIN ISCHEMIA MODIFIED", "code_information": [{"code": "82045", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUTEROL COMP CON", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7610", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUTEROL COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7609", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUTEROL IPRATROP NON-COMP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7620", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUTEROL NON-COMP CON", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7611", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALBUTEROL NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7613", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG ASSESS", "code_information": [{"code": "H0001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG HOTLINE", "code_information": [{"code": "H0030", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG INTERVEN", "code_information": [{"code": "H0022", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG OUTREACH", "code_information": [{"code": "H0023", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0024", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0025", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0026", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0027", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0028", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG PREVENTI", "code_information": [{"code": "H0029", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SCREENIN", "code_information": [{"code": "H0002", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SCREENIN", "code_information": [{"code": "H0003", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0004", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0005", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0006", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0007", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0008", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0009", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0011", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0012", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0013", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0014", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0015", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0016", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0017", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0018", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0019", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG SERVICES", "code_information": [{"code": "H0020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL AND/OR DRUG TRAINING", "code_information": [{"code": "H0021", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL OR PEROXIDE PER PINT", "code_information": [{"code": "A4244", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL WIPES PER BOX", "code_information": [{"code": "A4245", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY", "code_information": [{"code": "895", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC", "code_information": [{"code": "896", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC", "code_information": [{"code": "897", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA", "code_information": [{"code": "894", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/DRUG ABUSE SVC NOS", "code_information": [{"code": "H0047", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/DRUG SCREENING", "code_information": [{"code": "H0049", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/DRUG SERVICE 15 MIN", "code_information": [{"code": "H0050", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/SUB MISUSE ASSESS", "code_information": [{"code": "G2011", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/SUBS INTERV 15-30MN", "code_information": [{"code": "G0396", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/SUBS INTERV >30 MIN", "code_information": [{"code": "G0397", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOL/SUBSTANCE ABUSE SKIL", "code_information": [{"code": "T1012", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOLS BIOMARKERS 1OR 2", "code_information": [{"code": "80321", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALCOHOLS BIOMARKERS 3/MORE", "code_information": [{"code": "80322", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD BLU TOOTH FM/DM RECEIVER", "code_information": [{"code": "V5286", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM ADAPT/BOOT COUPLIN", "code_information": [{"code": "V5289", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM AUD INPUT RECEIVER", "code_information": [{"code": "V5285", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM EAR LEVEL RECEIVER", "code_information": [{"code": "V5284", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM RECEIVER, NOS", "code_information": [{"code": "V5287", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM SYSTEM BINAURAL", "code_information": [{"code": "V5282", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM SYSTEM, MONAURAL", "code_information": [{"code": "V5281", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FM/DM TRANSMITTER ALD", "code_information": [{"code": "V5288", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD FOR COCHLEAR IMPLANT", "code_information": [{"code": "V5273", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD NECK, LOOP IND RECEIVER", "code_information": [{"code": "V5283", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD TELEPHONE AMPLIFIER", "code_information": [{"code": "V5268", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD TRANSMITTER MICROPHONE", "code_information": [{"code": "V5290", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD UNSPECIFIED", "code_information": [{"code": "V5274", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD, TV AMPLIFIER, ANY TYPE", "code_information": [{"code": "V5270", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALD, TV CAPTION DECODER", "code_information": [{"code": "V5271", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALDESLEUKIN INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9015", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALDOSTERONE SUPPRESSION EVAL", "code_information": [{"code": "80408", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALEFACEPT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0215", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALERT DEVICE, NOC", "code_information": [{"code": "A9280", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALERTING DEVICE, ANY TYPE", "code_information": [{"code": "V5269", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALGINATE DRESSING > 48 SQ IN", "code_information": [{"code": "A6198", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALGLUCERASE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0205", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALGLUCOSIDASE ALFA INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0220", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALKALOIDS NOS", "code_information": [{"code": "80323", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLERGEN SPECIFIC IGG", "code_information": [{"code": "86001", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLERGIC REACTIONS WITH MCC", "code_information": [{"code": "915", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLERGIC REACTIONS WITHOUT MCC", "code_information": [{"code": "916", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLERGY PATCH TESTS", "code_information": [{"code": "95044", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLERGY/IMMUNOLOGY SS", "code_information": [{"code": "G0060", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLG SPEC IGE CRUDE XTRC EA", "code_information": [{"code": "86003", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLG SPEC IGE MULTIALLG SCR", "code_information": [{"code": "86005", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLG SPEC IGE RECOMB EA", "code_information": [{"code": "86008", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLGRFT IMPLNT KNEE W/SCOPE", "code_information": [{"code": "29867", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLODERM", "code_information": [{"code": "Q4116", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOGEN, PER CC", "code_information": [{"code": "Q4212", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOGENEIC BONE MARROW TRANSPLANT", "code_information": [{"code": "14", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOSKIN", "code_information": [{"code": "Q4115", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOSKIN", "code_information": [{"code": "Q4123", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOSKIN AC, 1 CM", "code_information": [{"code": "Q4141", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALLOWRAP DS OR DRY 1 SQ CM", "code_information": [{"code": "Q4150", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA 1 PROTEINASE INHIBITOR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0256", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA-1-ANTITRYPSIN PHENO", "code_information": [{"code": "82104", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA-1-ANTITRYPSIN TOTAL", "code_information": [{"code": "82103", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA-FETOPROTEIN AMNIOTIC", "code_information": [{"code": "82106", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA-FETOPROTEIN L3", "code_information": [{"code": "82107", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPHA-FETOPROTEIN SERUM", "code_information": [{"code": "82105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPROSTADIL FOR INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0270", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALPROSTADIL URETHRAL SUPPOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0275", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS 1", "code_information": [{"code": "A0426", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS 2", "code_information": [{"code": "A0433", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS DEFIBRILLATION SUPPLIES", "code_information": [{"code": "A0392", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS ESOPHAGEAL INTUB SUPPLS", "code_information": [{"code": "A0396", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS IV DRUG THERAPY SUPPLIES", "code_information": [{"code": "A0394", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS ROUTINE DISPOSBLE SUPPLS", "code_information": [{"code": "A0398", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALS1-EMERGENCY", "code_information": [{"code": "A0427", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALT LONG-TERM CNTRL MED RXD", "code_information": [{"code": "4144F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALTEPLASE 100 MG VIAL", "drug_information": {"unit": 1.0, "type": "ME"}, "code_information": [{"code": "J2997", "type": "HCPCS"}, {"code": "4710168", "type": "CDM"}, {"code": "50242008527", "type": "NDC"}, {"code": "250", "type": "RC"}], "standard_charges": [{"minimum": 8480.0, "maximum": 15840.0, "gross_charge": 16000.0, "discounted_cash": 16000.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 15840.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 14400.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 14256.0, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ALTUVIIIO PER FACTOR VIII IU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7214", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOLOPLASTY NOT W/EXTRACTS", "code_information": [{"code": "D7321", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOLOPLASTY W/EXTRACT 1-3", "code_information": [{"code": "D7311", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOLUS CLSD REDUC STBLZ TE", "code_information": [{"code": "D7771", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOLUS OPEN REDUCTION", "code_information": [{"code": "D7671", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOPLASTY W/ EXTRACTION", "code_information": [{"code": "D7310", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALVEOPLASTY W/O EXTRACTION", "code_information": [{"code": "D7320", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS BRN NPGT PRGRMG 15 MIN", "code_information": [{"code": "95983", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS BRN NPGT PRGRMG ADDL 15", "code_information": [{"code": "95984", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS CPLX CN NPGT PRGRMG", "code_information": [{"code": "95977", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS CPLX SP/PN NPGT W/PRGRM", "code_information": [{"code": "95972", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS NPGT W/O PRGRMG", "code_information": [{"code": "95970", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS SMPL CN NPGT PRGRMG", "code_information": [{"code": "95976", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ALYS SMPL SP/PN NPGT W/PRGRM", "code_information": [{"code": "95971", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMALGAM 4 OR > SURFACES PERM", "code_information": [{"code": "D2161", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMALGAM ONE SURFACE PERMANEN", "code_information": [{"code": "D2140", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMALGAM THREE SURFACES PERMA", "code_information": [{"code": "D2160", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMALGAM TWO SURFACES PERMANE", "code_information": [{"code": "D2150", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBL BP MNTR W/SOFTWARE", "code_information": [{"code": "93784", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBL BP MNTR W/SW A/R", "code_information": [{"code": "93788", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBL BP MNTR W/SW I&R", "code_information": [{"code": "93790", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBL BP MNTR W/SW REC ONLY", "code_information": [{"code": "93786", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULANCE 02 LIFE SUSTAINING", "code_information": [{"code": "A0422", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULANCE RESPONSE/TREATMENT", "code_information": [{"code": "A0998", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULANCE WAITING 1/2 HR", "code_information": [{"code": "A0420", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULATORY SETTING SUBSTANCE", "code_information": [{"code": "S9475", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULATORY SURGICAL BOOT EAC", "code_information": [{"code": "L3260", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMBULATORY TRACTION DEVICE", "code_information": [{"code": "E0830", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMIFOSTINE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0207", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMIKACIN SULFATE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0278", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINES VAGINAL FLUID QUAL", "code_information": [{"code": "82120", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINO ACID SINGLE QUAL", "code_information": [{"code": "82127", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINO ACIDS MULT QUAL", "code_information": [{"code": "82128", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINO ACIDS QUAN 6 OR MORE", "code_information": [{"code": "82139", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINO ACIDS QUANT 2-5", "code_information": [{"code": "82136", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINO ACIDS SINGLE QUANT", "code_information": [{"code": "82131", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINOLEVULINIC ACID HCL TOP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7308", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINOLEVULINIC ACID, 10% GEL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7345", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMINOPHYLLIN 250 MG INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0280", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMIODARONE HCL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0282", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMITRIPTYLINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1320", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMMONIA TEST STRIPS", "code_information": [{"code": "A4774", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNICORE PRO+, PER SQ CM", "code_information": [{"code": "Q4299", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNICORE PRO, PER SQ CM", "code_information": [{"code": "Q4298", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO OR BIODMATRIX, INJ 1CC", "code_information": [{"code": "Q4139", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO OR DERMA TL, PER SQ CM", "code_information": [{"code": "Q4225", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO QUAD-CORE, PER SQ CM", "code_information": [{"code": "Q4294", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO TRI-CORE, PER SQ CM", "code_information": [{"code": "Q4295", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO WOUND, PER SQUARE CM", "code_information": [{"code": "Q4181", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIO-MAXX OR LITE PER SQ CM", "code_information": [{"code": "Q4239", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOAMP-MP PER SQ CM", "code_information": [{"code": "Q4250", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOARMOR 1 SQ CM", "code_information": [{"code": "Q4188", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOBAND, 1 MG", "code_information": [{"code": "Q4168", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOBAND, GUARDIAN 1 SQ CM", "code_information": [{"code": "Q4151", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS DIAGNOSTIC", "code_information": [{"code": "59000", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOCENTESIS THERAPEUTIC", "code_information": [{"code": "59001", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOCORE PER SQ CM", "code_information": [{"code": "Q4227", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOCYTE PLUS, PER 0.5 CC", "code_information": [{"code": "Q4242", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOEXCEL BIODEXCEL 1SQ CM", "code_information": [{"code": "Q4137", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNION BIO OR AXOBIO SQ CM", "code_information": [{"code": "Q4211", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOREPAIR OR ALTIPLY SQ CM", "code_information": [{"code": "Q4235", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOTEXT PATCH, PER SQ CM", "code_information": [{"code": "Q4247", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOTEXT, PER CC", "code_information": [{"code": "Q4245", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOTIC FLUID SCAN", "code_information": [{"code": "82143", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOTIC MEMBRANE", "code_information": [{"code": "V2790", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIOWRAP2 PER SQ CM", "code_information": [{"code": "Q4221", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNIPLY, PER SQ CM", "code_information": [{"code": "Q4249", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNT PAIN NOTED NONE PRSNT", "code_information": [{"code": "1126F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMNT PAIN NOTED PAIN PRSNT", "code_information": [{"code": "1125F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMOBARBITAL 125 MG INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0300", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMOX W/WO CLAV RX", "code_information": [{"code": "G9315", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMOXIC NOT PRESC AS 1ST LINE", "code_information": [{"code": "G9313", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHETAMINES 3OR 4", "code_information": [{"code": "80325", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHETAMINES 5 OR MORE", "code_information": [{"code": "80326", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHO B CHOLESTERYL SULFATE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0288", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHOTERICIN B", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0285", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHOTERICIN B LIPID COMPLEX", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0287", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPHOTERICIN B LIPOSOME INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0289", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPICILLIN 500 MG INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0290", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPICILLIN SULBACTAM 1.5 GM", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0295", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPU. FINGER/THUMB", "code_information": [{"code": "26951", "type": "CPT"}, {"code": "4011577", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"minimum": 1908.0, "maximum": 3564.0, "gross_charge": 3600.0, "discounted_cash": 3600.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 1908.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 3564.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 3240.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 3207.6, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 3060.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 1908.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 3060.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 1908.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "AMPUTATE HAND AT WRIST", "code_information": [{"code": "25920", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE HAND AT WRIST", "code_information": [{"code": "25922", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE LEG AT THIGH", "code_information": [{"code": "27590", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE LEG AT THIGH", "code_information": [{"code": "27591", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE LEG AT THIGH", "code_information": [{"code": "27592", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE LOWER LEG AT KNEE", "code_information": [{"code": "27598", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE METACARPAL BONE", "code_information": [{"code": "26910", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATE UPPER ARM & IMPLANT", "code_information": [{"code": "24931", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "24925", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "24930", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "25907", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "25909", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "25924", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "25929", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "25931", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "27594", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "27596", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "27884", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOLLOW-UP SURGERY", "code_information": [{"code": "27886", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC", "code_information": [{"code": "240", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC", "code_information": [{"code": "239", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"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", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC", "code_information": [{"code": "475", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC", "code_information": [{"code": "474", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC", "code_information": [{"code": "476", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FINGER/THUMB", "code_information": [{"code": "26952", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FOOT AT ANKLE", "code_information": [{"code": "27888", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FOOT AT ANKLE", "code_information": [{"code": "27889", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FOREARM", "code_information": [{"code": "25900", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FOREARM", "code_information": [{"code": "25905", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF FOREARM", "code_information": [{"code": "25915", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF HAND", "code_information": [{"code": "25927", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LEG AT HIP", "code_information": [{"code": "27290", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LEG AT HIP", "code_information": [{"code": "27295", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LEG", "code_information": [{"code": "27880", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LEG", "code_information": [{"code": "27881", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LEG", "code_information": [{"code": "27882", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC", "code_information": [{"code": "617", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC", "code_information": [{"code": "616", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC", "code_information": [{"code": "618", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF MIDFOOT", "code_information": [{"code": "28800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF TOE", "code_information": [{"code": "28820", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF UPPER ARM", "code_information": [{"code": "24900", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION OF UPPER ARM", "code_information": [{"code": "24920", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION THRU METATARSAL", "code_information": [{"code": "28805", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AMPUTATION TOE & METATARSAL", "code_information": [{"code": "28810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANA CROWN EXP 1-3 PER QUAD", "code_information": [{"code": "D4231", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANA CROWN EXP 4 OR> PER QUAD", "code_information": [{"code": "D4230", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANABOLIC STEROID 1 OR 2", "code_information": [{"code": "80327", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANABOLIC STEROID 3 OR MORE", "code_information": [{"code": "80328", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANACAULASE-BCDB 8.8% GEL 1 G", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7353", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL AND STOMAL PROCEDURES WITH CC", "code_information": [{"code": "348", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL AND STOMAL PROCEDURES WITH MCC", "code_information": [{"code": "347", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC", "code_information": [{"code": "349", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL PRESSURE RECORD", "code_information": [{"code": "91122", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL SP INF PMP W/REPRG&FILL", "code_information": [{"code": "62369", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL/URINARY MUSCLE STUDY", "code_information": [{"code": "51784", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAL/URINARY MUSCLE STUDY", "code_information": [{"code": "51785", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALGESIA", "code_information": [{"code": "D9230", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALGESICS NON-OPIOID 1 OR 2", "code_information": [{"code": "80329", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALGESICS NON-OPIOID 3-5", "code_information": [{"code": "80330", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALGESICS NON-OPIOID 6/MORE", "code_information": [{"code": "80331", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYSIS NERVE", "code_information": [{"code": "88356", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYSIS OF SALIVA SAMPLE", "code_information": [{"code": "D0418", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYSIS TUMOR", "code_information": [{"code": "88358", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYZE PACEMAKER SYSTEM", "code_information": [{"code": "93724", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYZE SP INF PUMP W/REPROG", "code_information": [{"code": "62368", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANALYZE SPINE INFUS PUMP", "code_information": [{"code": "62367", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANAPLSMA PHGCYTOPHLM AMP PRB", "code_information": [{"code": "87468", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANASTOMOSIS/ARTERY-AORTA", "code_information": [{"code": "33606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANASTROZOLE 1 MG", "code_information": [{"code": "S0170", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANBX 30 PRIOR TO EPISODE", "code_information": [{"code": "G9703", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANCA SCREEN EACH ANTIBODY", "code_information": [{"code": "86036", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANCA TITER EACH ANTIBODY", "code_information": [{"code": "86037", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANCHOR/SCREW BN/BN,TIS/BN", "code_information": [{"code": "C1713", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANDROLOGY INFERTILITY ASSMT", "code_information": [{"code": "255U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANDROSTANEDIOL GLUCURONIDE", "code_information": [{"code": "82154", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANEMIA PLAN OF CARE DOCD", "code_information": [{"code": "516F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES C HYST FLWG NEURAXIAL", "code_information": [{"code": "1969", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES CESAREAN DELIVERY ONLY", "code_information": [{"code": "1961", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES CESAREAN HYSTERECTOMY", "code_information": [{"code": "1963", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES COMP CTRLD HYPOTENSION", "code_information": [{"code": "99135", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES COMP EMERGENCY COND", "code_information": [{"code": "99140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES COMP TOT BDY HYPTHRM", "code_information": [{"code": "99116", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES DRG/ASPIR CRV/THRC", "code_information": [{"code": "1937", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES DRG/ASPIR LMBR/SAC", "code_information": [{"code": "1938", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES DX SHOULDER ARTHROSCOPY", "code_information": [{"code": "1622", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES END, 1 TEMP >35.5(95.9)", "code_information": [{"code": "G9771", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES HRNA RPR DIPHRG HRNA", "code_information": [{"code": "756", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES HRNA RPR LMBR&VNT&/DEHS", "code_information": [{"code": "752", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES HRNA RPR OMPHALOCELE", "code_information": [{"code": "754", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES HRNA RPR UPR ABD NOS", "code_information": [{"code": "750", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES INCOMPL/MISSED AB PX", "code_information": [{"code": "1965", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES INDUCED ABORTION PX", "code_information": [{"code": "1966", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES IPER UPR ABD GSTR PX MO", "code_information": [{"code": "797", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES IPER UPR ABD LVR TRNSPL", "code_information": [{"code": "796", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES IPER UPR ABD NOS", "code_information": [{"code": "790", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES IPER UPR ABD PNCRTECT", "code_information": [{"code": "794", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES IPER UPR ABD PRTL HPTC", "code_information": [{"code": "792", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES LWR INTST NDSC NOS", "code_information": [{"code": "811", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES LWR INTST SCR COLSC", "code_information": [{"code": "812", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES MEDIASCPY & DX THORSCPY", "code_information": [{"code": "528", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES MEDSCPY&THORSCPY 1 LUNG", "code_information": [{"code": "529", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES NEUROMD/NTRVRT CRV/THRC", "code_information": [{"code": "1941", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES NEUROMD/NTRVRT LMBR/SAC", "code_information": [{"code": "1942", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES NULYT AGT CRV/THRC", "code_information": [{"code": "1939", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES NULYT AGT LMBR/SAC", "code_information": [{"code": "1940", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES PT EXTEME AGE<1 YR&>70", "code_information": [{"code": "99100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES PX MAJ ABD BLOOD VESSEL", "code_information": [{"code": "770", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES SPINE TRANSTHOR W/VENT", "code_information": [{"code": "626", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES SPINE TRANTHOR W/O VENT", "code_information": [{"code": "625", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES THER INTERVEN RAD ARTRL", "code_information": [{"code": "1924", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES THER INTERVEN RAD CARD", "code_information": [{"code": "1925", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES THER INTERVEN RAD TIPS", "code_information": [{"code": "1931", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES THER INTERVEN RAD VEIN", "code_information": [{"code": "1930", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES TX INTERV RAD CRAN VEIN", "code_information": [{"code": "1933", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES TX INTERV RAD HRT/CRAN", "code_information": [{"code": "1926", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES TX INTERV RAD TH VEIN", "code_information": [{"code": "1932", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES UPR GI NDSC PX ERCP", "code_information": [{"code": "732", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES UPR GI NDSC PX NOS", "code_information": [{"code": "731", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES UPR LWR GI NDSC PX", "code_information": [{"code": "813", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES URGENT HYSTERECTOMY", "code_information": [{"code": "1962", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES VAGINAL DELIVERY ONLY", "code_information": [{"code": "1960", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES XTRNL CEPHALIC VERSION", "code_information": [{"code": "1958", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANES/ANALG CS DLVR NEURAXIAL", "code_information": [{"code": "1968", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH 60 MIN/> AS DOCD", "code_information": [{"code": "4255F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ABDOMEN VESSEL SURG", "code_information": [{"code": "880", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ABDOMINAL WALL SURG", "code_information": [{"code": "700", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ABDOMINAL WALL SURG", "code_information": [{"code": "730", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ABDOMINAL WALL SURG", "code_information": [{"code": "800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ABDOMINAL WALL SURG", "code_information": [{"code": "820", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ACHILLES TENDON SURG", "code_information": [{"code": "1472", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH AMNIOCENTESIS", "code_information": [{"code": "842", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH AMPUTATION AT KNEE", "code_information": [{"code": "1404", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH AMPUTATION AT PELVIS", "code_information": [{"code": "1140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH AMPUTATION OF FEMUR", "code_information": [{"code": "1232", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH AMPUTATION OF PENIS", "code_information": [{"code": "932", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ANKLE REPLACEMENT", "code_information": [{"code": "1486", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ANKLE/FT ARTHROSCOPY", "code_information": [{"code": "1464", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ANORECTAL SURGERY", "code_information": [{"code": "902", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ARM-LEG VESSEL SURG", "code_information": [{"code": "1656", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ARTHROSCOPY OF HIP", "code_information": [{"code": "1202", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BICEPS TENDON REPAIR", "code_information": [{"code": "1716", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BIOPSY OF NOSE", "code_information": [{"code": "164", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BIOPSY OF THYROID", "code_information": [{"code": "322", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BLADDER STONE SURG", "code_information": [{"code": "870", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BLADDER SURGERY", "code_information": [{"code": "910", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BLADDER TUMOR SURG", "code_information": [{"code": "912", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BLEEDING CONTROL", "code_information": [{"code": "916", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BLEPHAROPLASTY", "code_information": [{"code": "103", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BODY CAST PROCEDURE", "code_information": [{"code": "1130", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BONE ASPIRATE/BX", "code_information": [{"code": "1112", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BURN 4-9 PERCENT", "code_information": [{"code": "1952", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BURN EACH 9 PERCENT", "code_information": [{"code": "1953", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH BURN LESS 4 PERCENT", "code_information": [{"code": "1951", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CABG W/O PUMP", "code_information": [{"code": "566", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CABG W/PUMP", "code_information": [{"code": "567", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CARDIAC ELECTROPHYS", "code_information": [{"code": "537", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CARDIOVERTER/DEFIB", "code_information": [{"code": "534", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CAT OR MRI SCAN", "code_information": [{"code": "1922", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CATHETERIZE HEART", "code_information": [{"code": "1920", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CHEST DRAINAGE", "code_information": [{"code": "524", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CHEST LINING BIOPSY", "code_information": [{"code": "522", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CHEST PROCEDURE", "code_information": [{"code": "520", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CHEST SURGERY", "code_information": [{"code": "540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CHEST WALL REPAIR", "code_information": [{"code": "472", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CLEFT PALATE REPAIR", "code_information": [{"code": "172", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH COLLAR BONE BIOPSY", "code_information": [{"code": "454", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CORNEAL TRANSPLANT", "code_information": [{"code": "144", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CORRECT HEART RHYTHM", "code_information": [{"code": "410", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CRAN SURG HEMOTOMA", "code_information": [{"code": "211", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH CRANIAL SURG NOS", "code_information": [{"code": "210", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH DX ARTERIOGRAPHY", "code_information": [{"code": "1916", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH DX ELBOW ARTHROSCOPY", "code_information": [{"code": "1732", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH DX KNEE ARTHROSCOPY", "code_information": [{"code": "1382", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH DX WRIST ARTHROSCOPY", "code_information": [{"code": "1829", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH EAR EXAM", "code_information": [{"code": "124", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH EAR SURGERY", "code_information": [{"code": "120", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ELBOW AREA SURGERY", "code_information": [{"code": "1710", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ELBOW REPLACEMENT", "code_information": [{"code": "1760", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ELECTROSHOCK", "code_information": [{"code": "104", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ESOPHAGEAL SURGERY", "code_information": [{"code": "500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH EYE EXAM", "code_information": [{"code": "148", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FACE/SKULL BONE SURG", "code_information": [{"code": "190", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FACIAL BONE SURGERY", "code_information": [{"code": "192", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FAT LAYER REMOVAL", "code_information": [{"code": "802", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FEMORAL ARTERY SURG", "code_information": [{"code": "1272", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FEMORAL EMBOLECTOMY", "code_information": [{"code": "1274", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FOR LIVER BIOPSY", "code_information": [{"code": "702", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FOREQUARTER AMPUT", "code_information": [{"code": "1636", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH FX REPAIR PELVIS", "code_information": [{"code": "1173", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH GENITALIA SURGERY", "code_information": [{"code": "920", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEAD NERVE SURGERY", "code_information": [{"code": "222", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEAD VESSEL SURGERY", "code_information": [{"code": "216", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEAD/NECK/PTRUNK", "code_information": [{"code": "300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEART SURG <1 YR", "code_information": [{"code": "561", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEART SURG W/ARREST", "code_information": [{"code": "563", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEART SURG W/O PUMP", "code_information": [{"code": "560", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HEART/LUNG TRANSPLNT", "code_information": [{"code": "580", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HERNIA REPAIR < 1 YR", "code_information": [{"code": "834", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HERNIA REPAIR PREEMIE", "code_information": [{"code": "836", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HIP ARTHROPLASTY", "code_information": [{"code": "1214", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HIP DISARTICULATION", "code_information": [{"code": "1212", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HIP JOINT PROCEDURE", "code_information": [{"code": "1200", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HIP JOINT SURGERY", "code_information": [{"code": "1210", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HRT SURG W/PMP AGE 1+", "code_information": [{"code": "562", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HUMERAL LESION SURG", "code_information": [{"code": "1758", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HUMERUS REPAIR", "code_information": [{"code": "1744", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HUMERUS SURGERY", "code_information": [{"code": "1742", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HYSTERECTOMY", "code_information": [{"code": "846", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH HYSTEROSCOPE/GRAPH", "code_information": [{"code": "952", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH INSERT PENIS DEVICE", "code_information": [{"code": "938", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH INTRCRN NERVE", "code_information": [{"code": "220", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH IRIDECTOMY", "code_information": [{"code": "147", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KIDNEY STONE DESTRUCT", "code_information": [{"code": "872", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KIDNEY STONE DESTRUCT", "code_information": [{"code": "873", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KIDNEY TRANSPLANT", "code_information": [{"code": "868", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KIDNEY/URETER SURG", "code_information": [{"code": "862", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE AREA PROCEDURE", "code_information": [{"code": "1340", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE AREA PROCEDURE", "code_information": [{"code": "1390", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE AREA SURGERY", "code_information": [{"code": "1320", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE AREA SURGERY", "code_information": [{"code": "1360", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE AREA SURGERY", "code_information": [{"code": "1392", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE ARTERIES SURG", "code_information": [{"code": "1440", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE ARTERY REPAIR", "code_information": [{"code": "1444", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE ARTERY SURG", "code_information": [{"code": "1442", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE ARTHROPLASTY", "code_information": [{"code": "1402", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE JOINT CASTING", "code_information": [{"code": "1420", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE JOINT PROCEDURE", "code_information": [{"code": "1380", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE JOINT SURGERY", "code_information": [{"code": "1400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE VEINS SURGERY", "code_information": [{"code": "1430", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH KNEE VESSEL SURG", "code_information": [{"code": "1432", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LARYNX/TRACH < 1 YR", "code_information": [{"code": "326", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LEG ARTERIES SURG", "code_information": [{"code": "1500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LENS SURGERY", "code_information": [{"code": "142", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER ARM CASTING", "code_information": [{"code": "1860", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER ARM PROCEDURE", "code_information": [{"code": "1820", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER ARM SURGERY", "code_information": [{"code": "1810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER ARM SURGERY", "code_information": [{"code": "1830", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER ARM VEIN SURG", "code_information": [{"code": "1850", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG BONE SURG", "code_information": [{"code": "1480", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG CASTING", "code_information": [{"code": "1490", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG PROCEDURE", "code_information": [{"code": "1462", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG REVISION", "code_information": [{"code": "1484", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG SURGERY", "code_information": [{"code": "1470", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG SURGERY", "code_information": [{"code": "1474", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG VEIN SURG", "code_information": [{"code": "1520", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LOWER LEG VEIN SURG", "code_information": [{"code": "1522", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LUMBAR PUNCTURE", "code_information": [{"code": "635", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LUNG CHEST WALL SURG", "code_information": [{"code": "546", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LWR ARM ARTERY SURG", "code_information": [{"code": "1840", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LWR ARM EMBOLECTOMY", "code_information": [{"code": "1842", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LWR ARM VEIN REPAIR", "code_information": [{"code": "1852", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH LWR LEG EMBOLECTOMY", "code_information": [{"code": "1502", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH MAJOR VEIN LIGATION", "code_information": [{"code": "882", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH N BLOCK/INJ PRONE", "code_information": [{"code": "1992", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NECK ORGAN 1YR/>", "code_information": [{"code": "320", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NECK VESSEL SURGERY", "code_information": [{"code": "350", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NECK VESSEL SURGERY", "code_information": [{"code": "352", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NERVE BLOCK/INJ", "code_information": [{"code": "1991", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NOSE/SINUS SURGERY", "code_information": [{"code": "160", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH NOSE/SINUS SURGERY", "code_information": [{"code": "162", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH ONE LUNG VENTILATION", "code_information": [{"code": "541", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PACEMAKER INSERTION", "code_information": [{"code": "530", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIC ORGAN SURG", "code_information": [{"code": "848", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIC TUMOR SURGERY", "code_information": [{"code": "1150", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIS PROCEDURE", "code_information": [{"code": "1160", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIS SURGERY", "code_information": [{"code": "1120", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIS SURGERY", "code_information": [{"code": "1170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PELVIS SURGERY", "code_information": [{"code": "844", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PENIS NODES REMOVAL", "code_information": [{"code": "934", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PENIS NODES REMOVAL", "code_information": [{"code": "936", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PERINEAL SURGERY", "code_information": [{"code": "904", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PHARYNGEAL SURGERY", "code_information": [{"code": "174", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PHARYNGEAL SURGERY", "code_information": [{"code": "176", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PROCEDURE ON FEMUR", "code_information": [{"code": "1220", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PROCEDURE ON MOUTH", "code_information": [{"code": "170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH PROCEDURES ON EYE", "code_information": [{"code": "140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH RADICAL FEMUR SURG", "code_information": [{"code": "1234", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH RADICAL HUMERUS SURG", "code_information": [{"code": "1756", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH RADICAL LEG SURGERY", "code_information": [{"code": "1482", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF ADRENAL", "code_information": [{"code": "866", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF BLADDER", "code_information": [{"code": "864", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF NERVES", "code_information": [{"code": "632", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF PROSTATE", "code_information": [{"code": "865", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF PROSTATE", "code_information": [{"code": "908", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF PROSTATE", "code_information": [{"code": "914", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF RIB", "code_information": [{"code": "470", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF TESTIS", "code_information": [{"code": "926", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF TESTIS", "code_information": [{"code": "928", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REMOVAL OF VULVA", "code_information": [{"code": "906", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REPAIR OF CERVIX", "code_information": [{"code": "948", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REPAIR OF CLEFT LIP", "code_information": [{"code": "102", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REPAIR OF HERNIA", "code_information": [{"code": "830", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REPAIR OF HERNIA", "code_information": [{"code": "832", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH REVISE HIP REPAIR", "code_information": [{"code": "1215", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SALIVARY GLAND", "code_information": [{"code": "100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER ARTERY SURG", "code_information": [{"code": "1650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER CASTING", "code_information": [{"code": "1680", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER JOINT AMPUT", "code_information": [{"code": "1634", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER PROCEDURE", "code_information": [{"code": "1620", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER REPLACEMENT", "code_information": [{"code": "1638", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER VEIN SURG", "code_information": [{"code": "1670", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER VESSEL SURG", "code_information": [{"code": "1652", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SHOULDER VESSEL SURG", "code_information": [{"code": "1654", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SITTING PROCEDURE", "code_information": [{"code": "604", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SKIN EXT/PER/ATRUNK", "code_information": [{"code": "400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SKULL DRAINAGE", "code_information": [{"code": "212", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SKULL DRAINAGE", "code_information": [{"code": "214", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SKULL REPAIR/FRACT", "code_information": [{"code": "215", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPECIAL HEAD SURGERY", "code_information": [{"code": "218", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPERM DUCT SURGERY", "code_information": [{"code": "922", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPINE CORD SURGERY", "code_information": [{"code": "600", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPINE CORD SURGERY", "code_information": [{"code": "620", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPINE CORD SURGERY", "code_information": [{"code": "630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPINE CORD SURGERY", "code_information": [{"code": "670", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SPINE MANIPULATION", "code_information": [{"code": "640", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH STERNAL DEBRIDEMENT", "code_information": [{"code": "550", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH STONE REMOVAL", "code_information": [{"code": "918", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURG LOWER ABDOMEN", "code_information": [{"code": "840", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURG ON VAG/URETHRAL", "code_information": [{"code": "942", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF ABDOMEN", "code_information": [{"code": "860", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF BREAST", "code_information": [{"code": "402", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF BREAST", "code_information": [{"code": "404", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF BREAST", "code_information": [{"code": "406", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF FEMUR", "code_information": [{"code": "1230", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF RIB", "code_information": [{"code": "474", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF SHOULDER", "code_information": [{"code": "1610", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF SHOULDER", "code_information": [{"code": "1630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH SURGERY OF SHOULDER", "code_information": [{"code": "450", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TESTIS EXPLORATION", "code_information": [{"code": "924", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TESTIS SUSPENSION", "code_information": [{"code": "930", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH THIGH ARTERIES SURG", "code_information": [{"code": "1270", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TRACH-BRONCH RECONST", "code_information": [{"code": "539", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TRACHEA BRONCHI SURG", "code_information": [{"code": "548", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TUBAL LIGATION", "code_information": [{"code": "851", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH TYMPANOTOMY", "code_information": [{"code": "126", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPER ARM SURGERY", "code_information": [{"code": "1740", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPER ARM VEIN SURG", "code_information": [{"code": "1780", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPER LEG SURGERY", "code_information": [{"code": "1250", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPER LEG VEINS SURG", "code_information": [{"code": "1260", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM ARTERY SURG", "code_information": [{"code": "1770", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM EMBOLECTOMY", "code_information": [{"code": "1772", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM PROCEDURE", "code_information": [{"code": "1730", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM TENDON SURG", "code_information": [{"code": "1712", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM TENDON SURG", "code_information": [{"code": "1714", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH UPPR ARM VEIN REPAIR", "code_information": [{"code": "1782", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VAGINAL ENDOSCOPY", "code_information": [{"code": "950", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VAGINAL HYSTERECTOMY", "code_information": [{"code": "944", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VAGINAL PROCEDURES", "code_information": [{"code": "940", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VASCULAR ACCESS", "code_information": [{"code": "532", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VASCULAR SHUNT SURG", "code_information": [{"code": "1844", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VASECTOMY", "code_information": [{"code": "921", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH VITREORETINAL SURG", "code_information": [{"code": "145", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH W/O GEN/NEURAX ANESTH", "code_information": [{"code": "4560F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTH WRIST REPLACEMENT", "code_information": [{"code": "1832", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTHE <60 MIN AS DOCD", "code_information": [{"code": "4256F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTHESIA REMOVAL PLEURA", "code_information": [{"code": "542", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANESTHESIOLOGY SS", "code_information": [{"code": "G0061", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGINA ABSENT", "code_information": [{"code": "1012F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGINA PECTORIS", "code_information": [{"code": "311", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGINA PRESENT", "code_information": [{"code": "1011F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGIO FEM/POP W/ US", "code_information": [{"code": "C7531", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGIO W/ US NON-CORONARY", "code_information": [{"code": "C7532", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGIOSCOPY", "code_information": [{"code": "35400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANGIOTENSIN I ENZYME TEST", "code_information": [{"code": "82164", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANIDULAFUNGIN INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0348", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29891", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29892", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29894", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29895", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29897", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29898", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANKLE ARTHROSCOPY/SURGERY", "code_information": [{"code": "29899", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANL SP INF PMP W/MDREPRG&FIL", "code_information": [{"code": "62370", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANN BREAST EXAM", "code_information": [{"code": "S0613", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANNUAL ALCOHOL SCREEN 15 MIN", "code_information": [{"code": "G0442", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANNUAL GYNECOLOGICAL EXAMINA", "code_information": [{"code": "S0610", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANNUAL GYNECOLOGICAL EXAMINA", "code_information": [{"code": "S0612", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOGENITAL EXAM CHILD W IMAG", "code_information": [{"code": "99170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY", "code_information": [{"code": "46611", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY", "code_information": [{"code": "46615", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY AND BIOPSY", "code_information": [{"code": "46606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY AND DILATION", "code_information": [{"code": "46604", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY CONTROL BLEEDING", "code_information": [{"code": "46614", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY REMOVE FOR BODY", "code_information": [{"code": "46608", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY REMOVE LESION", "code_information": [{"code": "46610", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANOSCOPY REMOVE LESIONS", "code_information": [{"code": "46612", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANS PARASYMP & SYMP W/TILT", "code_information": [{"code": "95924", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANT RESIN-BASED CMPST CROWN", "code_information": [{"code": "D2390", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANT SGM IMG I&R SPECLR MIC", "code_information": [{"code": "92286", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANT SGM IMG IR FLRSCN ANGRPH", "code_information": [{"code": "92287", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANT THRC VRT BODY TETHRG 8+", "code_information": [{"code": "22837", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANT THRC VRT BODY TETHRG <7", "code_information": [{"code": "22836", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTB TP TOTAL&RPR IA QUAL", "code_information": [{"code": "64U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTEPARTUM CARE ONLY", "code_information": [{"code": "59425", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTEPARTUM CARE ONLY", "code_information": [{"code": "59426", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTEPARTUM MANAGEMENT", "code_information": [{"code": "H1001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTEPARTUM MANIPULATION", "code_information": [{"code": "59412", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTERIOR COLPORRHAPHY", "code_information": [{"code": "57240", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTERIOR GAIT TRAINER", "code_information": [{"code": "E8002", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTHRAX VACCINE SC OR IM", "code_information": [{"code": "90581", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI RHEUM DRUGTHXPYRXD/GVN", "code_information": [{"code": "4187F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI-EGFR MON ANTI THER", "code_information": [{"code": "G9839", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI-INFLM/ANLGSC AGENT RX", "code_information": [{"code": "4016F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI-INFLM/ANLGSC OTC ASSESS", "code_information": [{"code": "1007F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI-INHIBITOR", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7198", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTI-PHOSPHOLIPID ANTIBODY", "code_information": [{"code": "86148", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBIO RX W IN 10D OF SYMPT", "code_information": [{"code": "G9286", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBIOT NOT RXD/GIVEN", "code_information": [{"code": "4124F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBIOT RXD/GIVEN", "code_information": [{"code": "4120F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBIOTIC NOT PRES", "code_information": [{"code": "G8708", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBODY DETECTION NOS IF", "code_information": [{"code": "87299", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBODY SARS-COV-2 TITER(S)", "code_information": [{"code": "224U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIBODY TEST PUB HLTH PATH", "code_information": [{"code": "D0605", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTICOAG CLINIC PER SESSION", "code_information": [{"code": "S9401", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTICOAG MGMT PT WARFARIN", "code_information": [{"code": "93793", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTICOAG THX RX AT DISCHRG", "code_information": [{"code": "4075F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTICONV THXPY FOR 6 MOS/>", "code_information": [{"code": "4230F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTID GLBLN RCVD W/IN 26WKS", "code_information": [{"code": "4178F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRES RXTHXPY NOT RXD", "code_information": [{"code": "4063F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANT NOT SPECIFIED", "code_information": [{"code": "80338", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANT RX", "code_information": [{"code": "4064F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANT TRICYCLIC 1/2", "code_information": [{"code": "80335", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANT TRICYCLIC 3-5", "code_information": [{"code": "80336", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANTS CLASS 1 OR 2", "code_information": [{"code": "80332", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANTS CLASS 3-5", "code_information": [{"code": "80333", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIDEPRESSANTS CLASS 6/MORE", "code_information": [{"code": "80334", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIEMETIC DRUG ORAL NOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8597", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIEMETIC RECTAL/SUPP NOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J8498", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIEPILEPTICS NOS 1-3", "code_information": [{"code": "80339", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIEPILEPTICS NOS 4-6", "code_information": [{"code": "80340", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIEPILEPTICS NOS 7/MORE", "code_information": [{"code": "80341", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN TEST PUB HLTH PATHOG", "code_information": [{"code": "D0604", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95144", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of 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{"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95145", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95146", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95147", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95148", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of 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{"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95149", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95165", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIGEN THERAPY SERVICES", "code_information": [{"code": "95170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIHEMOPHILIC VIII/VWF COMP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7186", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIHIST/DECONG RX/RECOM", "code_information": [{"code": "4133F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTINOMYCES ANTIBODY", "code_information": [{"code": "86602", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTINUCLEAR ANTIBODIES", "code_information": [{"code": "86038", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTINUCLEAR ANTIBODIES (ANA)", "code_information": [{"code": "86039", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIPSYCHOTIC RX", "code_information": [{"code": "4065F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIPSYCHOTICS NOS 1-3", "code_information": [{"code": "80342", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIPSYCHOTICS NOS 4-6", "code_information": [{"code": "80343", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIPSYCHOTICS NOS 7/MORE", "code_information": [{"code": "80344", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTISPERM ANTIBODIES TEST", "code_information": [{"code": "S3655", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTISTREPTOLYSIN O SCREEN", "code_information": [{"code": "86063", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTISTREPTOLYSIN O TITER", "code_information": [{"code": "86060", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ACTIVITY", "code_information": [{"code": "85300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III ANTIGEN", "code_information": [{"code": "85301", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTITHROMBIN III INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7197", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTITHROMBIN RECOMBINANT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7196", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTITHYMOCYTE GLOBULN RABBIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7511", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTIVENIN CROTALIDAE VIAL", "drug_information": {"unit": 1.0, "type": "UN"}, "code_information": [{"code": "J0840", "type": "HCPCS"}, {"code": "4710163", "type": "CDM"}, {"code": "50633011012", "type": "NDC"}, {"code": "636", "type": "RC"}], "standard_charges": [{"minimum": 8480.0, "maximum": 15840.0, "gross_charge": 16000.0, "discounted_cash": 16000.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 15840.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 14400.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 14256.0, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ANTIVENOM (CROFAB)", "drug_information": {"unit": 1.0, "type": "ME"}, "code_information": [{"code": "J0840", "type": "HCPCS"}, {"code": "4710019", "type": "CDM"}, {"code": "50633011012", "type": "NDC"}, {"code": "250", "type": "RC"}], "standard_charges": [{"minimum": 8480.0, "maximum": 15840.0, "gross_charge": 16000.0, "discounted_cash": 16000.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 15840.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 14400.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 14256.0, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 13600.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 8480.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "ANTMC GUIDE 3D PRINT 1ST GD", "code_information": [{"code": "561T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTMC GUIDE 3D PRINT EA ADDL", "code_information": [{"code": "562T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTMC MDL 3D PRINT 1ST CMPNT", "code_information": [{"code": "559T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANTMC MDL 3D PRINT EA ADDL", "code_information": [{"code": "560T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ANY HYGIENIC ITEM, DEVICE", "code_information": [{"code": "A9286", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AOR ANE 5.5-5.9 CM MAX DIAM", "code_information": [{"code": "G9598", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AOR ANE >=6.0 CM MAX DIAM", "code_information": [{"code": "G9599", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC", "code_information": [{"code": "268", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC", "code_information": [{"code": "269", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC ANEURYSM 5-5.4CM DIAM", "code_information": [{"code": "9002F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC ANEURYSM<5CM DIAM CT", "code_information": [{"code": "9001F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC ANRYSM 6/> CM DIAM", "code_information": [{"code": "9004F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC ANRYSM5.5-5.9CM DIAM", "code_information": [{"code": "9003F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC CIRCULATION ASSIST", "code_information": [{"code": "33970", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC CIRCULATION ASSIST", "code_information": [{"code": "33971", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC DYSFUNCTION/DILATION", "code_information": [{"code": "81410", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC DYSFUNCTION/DILATION", "code_information": [{"code": "81411", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC HEMIARCH GRAFT", "code_information": [{"code": "33866", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AORTIC SUSPENSION", "code_information": [{"code": "33800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APC GENE DUP/DELET VARIANTS", "code_information": [{"code": "81203", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APC GENE FULL SEQUENCE", "code_information": [{"code": "81201", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APC GENE KNOWN FAM VARIANTS", "code_information": [{"code": "81202", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APC MRNA SEQ ALYS", "code_information": [{"code": "157U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APEXIFICATION/RECALC FINAL", "code_information": [{"code": "D3353", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APEXIFICATION/RECALC INITIAL", "code_information": [{"code": "D3351", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APEXIFICATION/RECALC INTERIM", "code_information": [{"code": "D3352", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHAKIA PROSTH SERVICE TEMP", "code_information": [{"code": "92358", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHERESIS IMMUNOADS SLCTV", "code_information": [{"code": "36516", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHERESIS PLASMA", "code_information": [{"code": "36514", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHERESIS PLATELETS", "code_information": [{"code": "36513", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHERESIS RBC", "code_information": [{"code": "36512", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHERESIS WBC", "code_information": [{"code": "36511", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APHLX TO VAX BEF ENC", "code_information": [{"code": "M1311", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APICALLY POSITIONED FLAP", "code_information": [{"code": "D4245", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APICOECTOMY - ANTERIOR", "code_information": [{"code": "D3410", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APIS, PER SQUARE CENTIMETER", "code_information": [{"code": "A2010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APLIGRAF", "code_information": [{"code": "Q4101", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APOL1 RISK VARIANTS", "code_information": [{"code": "355U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APOMORPHINE HYDROCHLORIDE", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0364", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MDLTY 1+CNTRST BTH EA 15", "code_information": [{"code": "97034", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MDLTY 1+HUBBRD TNK EA 15", "code_information": [{"code": "97036", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MDLTY 1+IONTPHRSIS EA 15", "code_information": [{"code": "97033", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MDLTY 1+ULTRASOUND EA 15", "code_information": [{"code": "97035", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MLTPLN UNI XTRNL FIX 1ST", "code_information": [{"code": "20696", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP MLTPLN UNI XTRNL FIX XCH", "code_information": [{"code": "20697", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP OF HYDROXYAPATITE", "code_information": [{"code": "D2991", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APP TOPICAL FLUORIDE VARNISH", "code_information": [{"code": "99188", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDECTOMY", "code_information": [{"code": "44950", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDECTOMY", "code_information": [{"code": "44960", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDECTOMY ADD-ON", "code_information": [{"code": "44955", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDICO-VESICOSTOMY", "code_information": [{"code": "50845", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDIX PROCEDURES WITH CC", "code_information": [{"code": "398", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDIX PROCEDURES WITH MCC", "code_information": [{"code": "397", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPENDIX PROCEDURES WITHOUT CC/MCC", "code_information": [{"code": "399", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL DESENSITIZING RESIN", "code_information": [{"code": "D9911", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL HALO CRANIAL 6+PINS", "code_information": [{"code": "20664", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL MLTPLN UNI EXT FIXJ SYS", "code_information": [{"code": "20692", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL MODALITY 1+ESTIM EA 15", "code_information": [{"code": "97032", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL MODALITY 1+LLLT PO PAIN", "code_information": [{"code": "97037", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL MULTLAY COMPRS ARM/HAND", "code_information": [{"code": "29584", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL SLVR DIAMN FLUORIDE 38%", "code_information": [{"code": "792T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPL UNIPLN UNI EXT FIXJ SYS", "code_information": [{"code": "20690", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLIANCE REMOVAL", "code_information": [{"code": "D7997", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION HALO CRANIAL", "code_information": [{"code": "20661", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION HALO FEMORAL", "code_information": [{"code": "20663", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION HALO PELVIC", "code_information": [{"code": "20662", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION LONG LEG SPLINT", "code_information": [{"code": "29505", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION LOWER LEG SPLINT", "code_information": [{"code": "29515", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29000", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29010", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29015", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29035", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29040", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29044", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF BODY CAST", "code_information": [{"code": "29046", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF FIGURE EIGHT", "code_information": [{"code": "29049", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF FINGER SPLINT", "code_information": [{"code": "29130", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF FINGER SPLINT", "code_information": [{"code": "29131", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF FOREARM CAST", "code_information": [{"code": "29075", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF HIP CAST", "code_information": [{"code": "29305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF HIP CASTS", "code_information": [{"code": "29325", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF LEG CAST", "code_information": [{"code": "29450", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF LONG ARM CAST", "code_information": [{"code": "29065", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF LONG LEG CAST", "code_information": [{"code": "29345", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF LONG LEG CAST", "code_information": [{"code": "29355", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF LONG LEG CAST", "code_information": [{"code": "29365", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF PASTE BOOT", "code_information": [{"code": "29580", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF SHOULDER CAST", "code_information": [{"code": "29055", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATION OF SHOULDER CAST", "code_information": [{"code": "29058", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLICATON ON-BODY INJECTOR", "code_information": [{"code": "96377", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY FINGER CAST", "code_information": [{"code": "29086", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY FOREARM SPLINT", "code_information": [{"code": "29125", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY FOREARM SPLINT", "code_information": [{"code": "29126", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY HAND/WRIST CAST", "code_information": [{"code": "29085", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY INTERSTIT RADIAT COMPL", "code_information": [{"code": "77778", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY INTRCAV RADIAT COMPL", "code_information": [{"code": "77763", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY INTRCAV RADIAT INTERM", "code_information": [{"code": "77762", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY INTRCAV RADIAT SIMPLE", "code_information": [{"code": "77761", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY LONG ARM SPLINT", "code_information": [{"code": "29105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY LONG LEG CAST BRACE", "code_information": [{"code": "29358", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY MULTLAY COMPRS LWR LEG", "code_information": [{"code": "29581", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY R&L PULM ART BANDS", "code_information": [{"code": "33620", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY REM FIXATION DEVICE", "code_information": [{"code": "20660", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY RIGID LEG CAST", "code_information": [{"code": "29445", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY SHORT LEG CAST", "code_information": [{"code": "29405", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY SHORT LEG CAST", "code_information": [{"code": "29425", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY SHORT LEG CAST", "code_information": [{"code": "29435", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY SRS HEADFRAME ADD-ON", "code_information": [{"code": "61800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPLY SURF LDR RADIONUCLIDE", "code_information": [{"code": "77789", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPRO RAD DS DVCS TECHS DOCD", "code_information": [{"code": "6040F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROP ACE/ARB TSTNG DONE", "code_information": [{"code": "4188F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROP ANTICONVULS TSTNG", "code_information": [{"code": "4191F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROP DIGOXIN TSTNG DONE", "code_information": [{"code": "4189F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROP DIURETIC TSTNG DONE", "code_information": [{"code": "4190F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROP ORAL REHYD RECOMMD", "code_information": [{"code": "4056F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APPROPOS MTHD OFFLOADING RXD", "code_information": [{"code": "4269F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "APROTONIN, 10,000 KIU", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0365", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQAPRN-4 ANTB FLO CYTMTRY EA", "code_information": [{"code": "86053", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQMBF PET REST & RX STRESS", "code_information": [{"code": "78434", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQMBF SPECT XERS/STRS & REST", "code_information": [{"code": "742T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQUAPORIN-4 ANTB CBA EACH", "code_information": [{"code": "86052", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQUAPORIN-4 ANTB ELISA", "code_information": [{"code": "86051", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQUATIC THERAPY/EXERCISES", "code_information": [{"code": "97113", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQUEOUS SHUNT EYE W/GRAFT", "code_information": [{"code": "66180", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AQUEOUS SHUNT EYE W/O GRAFT", "code_information": [{"code": "66179", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AR FULL SEQUENCE ANALYSIS", "code_information": [{"code": "230U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AR GENE CHARAC ALLELES", "code_information": [{"code": "81204", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AR GENE FULL GENE SEQUENCE", "code_information": [{"code": "81173", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AR GENE KNOWN FAMIL VARIANT", "code_information": [{"code": "81174", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARBUTAMINE HCL INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0395", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARCHITECT ECM PX FX 1 SQ CM", "code_information": [{"code": "Q4147", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARFORMOTEROL NON-COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7605", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARG II EXT COM/SUP/ACC MISC", "code_information": [{"code": "L8608", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN DIALYSIS (ACCORD)", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0892", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN DIALYSIS, AUROMED", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0899", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN ESRD DIALYSIS 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0884", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN NONESRD (ACCORD)", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0891", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN NONESRD (AUROMED)", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0898", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARGATROBAN NONESRD USE 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0883", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0400", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARIPIPRAZOLE LAUROXIL 1 MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J1944", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARSENIC TRIOXIDE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9017", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AOR-CELIAC-MSN-RENAL", "code_information": [{"code": "35631", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AORSUBCL/CAROT/INNOM", "code_information": [{"code": "35626", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AORTOBI-ILIAC", "code_information": [{"code": "35638", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AORTOBIFEMORAL", "code_information": [{"code": "35646", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AORTOFEMORAL", "code_information": [{"code": "35647", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AORTOILIAC", "code_information": [{"code": "35637", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AXILL-FEM-FEMORAL", "code_information": [{"code": "35654", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AXILLARY-AXILLARY", "code_information": [{"code": "35650", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AXILLARY-FEMORAL", "code_information": [{"code": "35621", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP AXILLARY-POP-TIBIAL", "code_information": [{"code": "35623", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP CAROTID-SUBCLAVIAN", "code_information": [{"code": "35606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP CAROTID-VERTEBRAL", "code_information": [{"code": "35642", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP COMMON IPSI CAROTID", "code_information": [{"code": "35601", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP FEM-ANT-POST TIB/PRL", "code_information": [{"code": "35566", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP FEM-ANT-POST TIB/PRL", "code_information": [{"code": "35666", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP FEMORAL-FEMORAL", "code_information": [{"code": "35661", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP FEMORAL-POPLITEAL", "code_information": [{"code": "35656", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AOR/CAROT/INNOM", "code_information": [{"code": "35526", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORCEL/AORMESEN", "code_information": [{"code": "35531", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORTBIFEMORAL", "code_information": [{"code": "35540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORTOBI-ILIAC", "code_information": [{"code": "35538", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORTOFEMORAL", "code_information": [{"code": "35539", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORTOILIAC", "code_information": [{"code": "35537", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AORTORENAL", "code_information": [{"code": "35560", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AXILL-BRACHIAL", "code_information": [{"code": "35522", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AXILL-FEMORAL", "code_information": [{"code": "35521", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AXILL/FEM/FEM", "code_information": [{"code": "35533", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT AXILLARY-AXILRY", "code_information": [{"code": "35518", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT BRACHIAL-BRCHL", "code_information": [{"code": "35525", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT BRCHL-ULNR-RDL", "code_information": [{"code": "35523", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT CAROTID-BRCHIAL", "code_information": [{"code": "35510", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT CAROTID-VERTBRL", "code_information": [{"code": "35508", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT CONTRAL CAROTID", "code_information": [{"code": "35509", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT FEM-FEMORAL", "code_information": [{"code": "35558", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT FEM-POPLITEAL", "code_information": [{"code": "35556", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT HEPATORENAL", "code_information": [{"code": "35535", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT ILIOFEMORAL", "code_information": [{"code": "35565", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT ILIOILIAC", "code_information": [{"code": "35563", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT IPSILAT CAROTID", "code_information": [{"code": "35501", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SPLENORENAL", "code_information": [{"code": "35536", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SUBCLAV-AXILARY", "code_information": [{"code": "35516", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SUBCLAV-BRCHIAL", "code_information": [{"code": "35512", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SUBCLAV-CAROTID", "code_information": [{"code": "35506", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SUBCLAV-SUBCLAV", "code_information": [{"code": "35511", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP GRFT SUBCLAV-VERTBRL", "code_information": [{"code": "35515", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP ILIO-CELIAC", "code_information": [{"code": "35632", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP ILIO-MESENTERIC", "code_information": [{"code": "35633", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP ILIOFEMORAL", "code_information": [{"code": "35665", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP ILIOILIAC", "code_information": [{"code": "35663", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP ILIORENAL", "code_information": [{"code": "35634", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP POP-TIBL-PRL-OTHER", "code_information": [{"code": "35571", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP POP-TIBL-PRL-OTHER", "code_information": [{"code": "35671", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP SPENORENAL", "code_information": [{"code": "35636", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP SUBCLAV-AXILLARY", "code_information": [{"code": "35616", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP SUBCLAV-SUBCLAVIAN", "code_information": [{"code": "35612", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP SUBCLAV-VERTEBRL", "code_information": [{"code": "35645", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART BYP TIBIAL-TIB/PERONEAL", "code_information": [{"code": "35570", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART OR VENOUS BLOOD TUBING", "code_information": [{"code": "A4750", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART PANCREAS EXT RECEIVER", "code_information": [{"code": "S1037", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART PANCREAS EXT TRANSMITTER", "code_information": [{"code": "S1036", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART PANCREAS INV DISP SENSOR", "code_information": [{"code": "S1035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART PANCREAS SYSTEM", "code_information": [{"code": "S1034", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART PRESSURE WAVEFORM ANALYS", "code_information": [{"code": "93050", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART TRNSPOSJ CAROTID SUBCLAV", "code_information": [{"code": "35695", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART TRNSPOSJ SUBCLAV CAROTID", "code_information": [{"code": "35694", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART TRNSPOSJ SUBCLAVIAN", "code_information": [{"code": "35693", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ART TRNSPOSJ VERTBRL CAROTID", "code_information": [{"code": "35691", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTACENT AC 1 SQ CM", "code_information": [{"code": "Q4190", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTACENT AC, 1 MG", "code_information": [{"code": "Q4189", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTACENT CORD PER SQ CM", "code_information": [{"code": "Q4216", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTACENT WOUND, PER SQ CM", "code_information": [{"code": "Q4169", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY EXPOS/GRAFT ARTERY", "code_information": [{"code": "33987", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY TO VEIN SHUNT", "code_information": [{"code": "36835", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY TRANSPOSE/ENDOVAS TAA", "code_information": [{"code": "33889", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAY EACH VESSEL", "code_information": [{"code": "75774", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS ABDOMEN", "code_information": [{"code": "75726", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS ADRENAL GLAND", "code_information": [{"code": "75731", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS ADRENALS", "code_information": [{"code": "75733", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS ARM/LEG", "code_information": [{"code": "75710", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS ARMS/LEGS", "code_information": [{"code": "75716", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS CHEST", "code_information": [{"code": "75756", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS LUNG", "code_information": [{"code": "75741", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS LUNG", "code_information": [{"code": "75746", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS LUNGS", "code_information": [{"code": "75743", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS PELVIS", "code_information": [{"code": "75736", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY X-RAYS SPINE", "code_information": [{"code": "75705", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY-VEIN AUTOGRAFT", "code_information": [{"code": "36825", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTERY-VEIN NONAUTOGRAFT", "code_information": [{"code": "36830", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHR SI JT OPN B1GRF INSTRM", "code_information": [{"code": "27280", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT DFRM 2-3 VRT SGM", "code_information": [{"code": "22808", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT DFRM 4-7 VRT SGM", "code_information": [{"code": "22810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT DFRM 8+ VRT SGM", "code_information": [{"code": "22812", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBD CERVICAL EA", "code_information": [{"code": "22552", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBD MIN DSC CRV", "code_information": [{"code": "22554", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBD MIN DSC EA", "code_information": [{"code": "22585", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBD MIN DSC LUM", "code_information": [{"code": "22558", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBD MIN DSC THC", "code_information": [{"code": "22556", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT NTRBDY CERVICAL", "code_information": [{"code": "22551", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD ANT TORAL/XORAL C1-C2", "code_information": [{"code": "22548", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD CMBN 1NTRSPC EA ADDL", "code_information": [{"code": "22634", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD CMBN 1NTRSPC LUMBAR", "code_information": [{"code": "22633", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD GLENOHUMERAL JT W/GRF", "code_information": [{"code": "23802", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD HIP JT SBTRCHC OSTEOT", "code_information": [{"code": "27286", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD LAT XTRCVTRY TQ EA AD", "code_information": [{"code": "22534", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD LAT XTRCVTRY TQ LMBR", "code_information": [{"code": "22533", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD LAT XTRCVTRY TQ THRC", "code_information": [{"code": "22532", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PRE-SAC NTRBDY L5-S1", "code_information": [{"code": "22586", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST DFRM 13+ VRT SGM", "code_information": [{"code": "22804", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST DFRM 7-12 VRT SGM", "code_information": [{"code": "22802", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST DFRM<6 VRT SGM", "code_information": [{"code": "22800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC CRV", "code_information": [{"code": "22600", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC EA ADD", "code_information": [{"code": "22614", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC LM EA", "code_information": [{"code": "22632", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC LUM", "code_information": [{"code": "22630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC LUMBAR", "code_information": [{"code": "22612", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ 1NTRSPC THRC", "code_information": [{"code": "22610", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ ATLAS-AXIS", "code_information": [{"code": "22595", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD PST TQ CRANIOCERVICAL", "code_information": [{"code": "22590", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD SI JT PERQ/MIN NVAS", "code_information": [{"code": "27279", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRD SI JT PRQ WO TFXJ DEV", "code_information": [{"code": "27278", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRO, LOOSE BODY + CHONDRO", "code_information": [{"code": "G0289", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRO/SHOUL SURG; W/SPACER", "code_information": [{"code": "C9781", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRODESIS GLENOHUMERAL JT", "code_information": [{"code": "23800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRODESIS HIP JOINT", "code_information": [{"code": "27284", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRODESIS SYMPHYSIS PUBIS", "code_information": [{"code": "27282", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHROEREISIS, SUBTALAR", "code_information": [{"code": "S2117", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHROFLEX", "code_information": [{"code": "Q4125", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHROSCOPY, SHOULDER, SURGI", "code_information": [{"code": "S2300", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRT ELBOW W/SYNOVECTOMY", "code_information": [{"code": "24102", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRT ELBW CAPSL EXC RLS", "code_information": [{"code": "24006", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRT ELBW EXPL DRG/RMVL FB", "code_information": [{"code": "24000", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRT ELBW JT EXPL BX RMVL", "code_information": [{"code": "24101", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTHRT ELBW SYNOVIAL BX ONLY", "code_information": [{"code": "24100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTIFICIAL INSEMINATION", "code_information": [{"code": "58321", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTIFICIAL INSEMINATION", "code_information": [{"code": "58322", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTIFICIAL LARYNX, ACCESSORY", "code_information": [{"code": "L8505", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ARTISS FIBRIN SEALANT", "code_information": [{"code": "C9250", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AS-AORT GRF F/AORTIC DSJ", "code_information": [{"code": "33858", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AS-AORT GRF F/DS OTH/THN DSJ", "code_information": [{"code": "33859", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASA/ANTIPLAT THER USED", "code_information": [{"code": "G8598", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASAY OF INTERLEUKIN-6 (IL-6)", "code_information": [{"code": "83529", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASCENDING AORTIC GRAFT", "code_information": [{"code": "33863", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASCENDING AORTIC GRAFT", "code_information": [{"code": "33864", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASCENT, 0.5 MG", "code_information": [{"code": "Q4213", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASCVD RISK >=20PCT", "code_information": [{"code": "M1364", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASHKENAZI JEWISH ASSOC DIS", "code_information": [{"code": "81412", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPA GENE", "code_information": [{"code": "81200", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPARAGINASE, NOS", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9020", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPERGILLUS AG IA", "code_information": [{"code": "87305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPERGILLUS ANTIBODY", "code_information": [{"code": "86606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIR/INJ THYROID CYST", "code_information": [{"code": "60300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRATE/INJ GANGLION CYST", "code_information": [{"code": "20612", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRATION ORBITAL CONTENTS", "code_information": [{"code": "67415", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRIN NOT USED, NO RSN", "code_information": [{"code": "M1057", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRIN RECVD W/IN 24 HRS", "code_information": [{"code": "4084F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRIN USED", "code_information": [{"code": "M1055", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASPIRIN/CLOPIDOGREL RXD", "code_information": [{"code": "4086F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY 17- KETOSTEROIDS", "code_information": [{"code": "83586", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ACID PHOSPHATASE", "code_information": [{"code": "84060", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ACTIVATED PROTEIN C", "code_information": [{"code": "85307", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ALKALINE PHOSPHATASE", "code_information": [{"code": "84075", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ALKALINE PHOSPHATASE", "code_information": [{"code": "84078", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ALKALINE PHOSPHATASES", "code_information": [{"code": "84080", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY AMINOLEVULINIC ACID", "code_information": [{"code": "82135", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY ANTI-MULLERIAN HORM", "code_information": [{"code": "82166", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY BLD/SERUM CHOLESTEROL", "code_information": [{"code": "82465", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY BLOOD CARBON DIOXIDE", "code_information": [{"code": "82374", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY BLOOD CATECHOLAMINES", "code_information": [{"code": "82383", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY C-D TRANSFER MEASURE", "code_information": [{"code": "82373", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY CARBAMAZEPINE FREE", "code_information": [{"code": "80157", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY CARBAMAZEPINE TOTAL", "code_information": [{"code": "80156", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY CARBOXYHB QUAL", "code_information": [{"code": "82376", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY CARBOXYHB QUANT", "code_information": [{"code": "82375", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY CHONDROITIN SULFATE", "code_information": [{"code": "82485", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY DIPROPYLACETIC ACD TOT", "code_information": [{"code": "80164", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY DIR MEAS FR ESTRADIOL", "code_information": [{"code": "82681", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY DUODENAL FLUID TRYPSIN", "code_information": [{"code": "84485", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY FOR CALPROTECTIN FECAL", "code_information": [{"code": "83993", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY FOR PHENCYCLIDINE", "code_information": [{"code": "83992", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY FREE HYDROXYPROLINE", "code_information": [{"code": "83500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY GALACTOSE TRANSFERASE", "code_information": [{"code": "82775", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY GLUCOSE BLOOD QUANT", "code_information": [{"code": "82947", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY GROWTH HORMONE (HGH)", "code_information": [{"code": "83003", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY IGA/IGD/IGG/IGM EACH", "code_information": [{"code": "82784", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY LIPOPROTEIN PLA2", "code_information": [{"code": "83698", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY MALATE DEHYDROGENASE", "code_information": [{"code": "83775", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY MYELOPEROXIDASE", "code_information": [{"code": "83876", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY NEPHELOMETRY NOT SPEC", "code_information": [{"code": "83883", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY NONENDOCRINE RECEPTOR", "code_information": [{"code": "84238", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF 17-HYDROXYPREGNENO", "code_information": [{"code": "84143", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF 5-HIAA", "code_information": [{"code": "83497", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ACTH", "code_information": [{"code": "82024", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ADP & AMP", "code_information": [{"code": "82030", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ALUMINUM", "code_information": [{"code": "82108", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ANDROSTERONE", "code_information": [{"code": "82160", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ANGIOTENSIN II", "code_information": [{"code": "82163", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF APOLIPOPROTEIN", "code_information": [{"code": "82172", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ARSENIC", "code_information": [{"code": "82175", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF B HEXOSAMINIDASE EA", "code_information": [{"code": "83080", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BETA-2 PROTEIN", "code_information": [{"code": "82232", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BIOTINIDASE", "code_information": [{"code": "82261", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD FATTY ACIDS", "code_information": [{"code": "82725", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD LIPOPROTEIN", "code_information": [{"code": "83719", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD LIPOPROTEIN", "code_information": [{"code": "83721", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD OSMOLALITY", "code_information": [{"code": "83930", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD PKU", "code_information": [{"code": "84030", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BLOOD/URIC ACID", "code_information": [{"code": "84550", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BRADYKININ", "code_information": [{"code": "82286", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF BREATH ETHANOL", "code_information": [{"code": "82075", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CADMIUM", "code_information": [{"code": "82300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CALCIUM", "code_information": [{"code": "82330", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CALCIUM IN URINE", "code_information": [{"code": "82340", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CARNITINE", "code_information": [{"code": "82379", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CAROTENE", "code_information": [{"code": "82380", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CATHEPSIN-D", "code_information": [{"code": "82387", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CHLORAMPHENICOL", "code_information": [{"code": "82415", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CHROMIUM", "code_information": [{"code": "82495", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CITRATE", "code_information": [{"code": "82507", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CK (CPK)", "code_information": [{"code": "82550", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF COPPER", "code_information": [{"code": "82525", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CORTICOSTERONE", "code_information": [{"code": "82528", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CPK IN BLOOD", "code_information": [{"code": "82552", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CREATINE", "code_information": [{"code": "82540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CREATININE", "code_information": [{"code": "82565", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CRYOFIBRINOGEN", "code_information": [{"code": "82585", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CRYOGLOBULIN", "code_information": [{"code": "82595", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CSF PROTEIN", "code_information": [{"code": "83873", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF CYANIDE", "code_information": [{"code": "82600", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF DIBUCAINE NUMBER", "code_information": [{"code": "82638", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF DIGOXIN FREE", "code_information": [{"code": "80163", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF DIGOXIN TOTAL", "code_information": [{"code": "80162", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ENDOCRINE HORMONE", "code_information": [{"code": "84235", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ERYTHROPOIETIN", "code_information": [{"code": "82668", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ESTRIOL", "code_information": [{"code": "82677", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ESTROGEN", "code_information": [{"code": "82672", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ESTROGEN", "code_information": [{"code": "84233", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ESTROGENS", "code_information": [{"code": "82671", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ESTRONE", "code_information": [{"code": "82679", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ETHYLENE GLYCOL", "code_information": [{"code": "82693", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ETIOCHOLANOLONE", "code_information": [{"code": "82696", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FECAL FAT", "code_information": [{"code": "82715", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FECES FOR TRYPSIN", "code_information": [{"code": "84490", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FECES PORPHYRINS", "code_information": [{"code": "84126", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FECES/UROBILINOGEN", "code_information": [{"code": "84577", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FERRITIN", "code_information": [{"code": "82728", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FETAL FIBRONECTIN", "code_information": [{"code": "82731", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FLUORIDE", "code_information": [{"code": "82735", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FOLIC ACID RBC", "code_information": [{"code": "82747", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FOLIC ACID SERUM", "code_information": [{"code": "82746", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FREE TESTOSTERONE", "code_information": [{"code": "84402", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF FREE THYROXINE", "code_information": [{"code": "84439", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF G6PD ENZYME", "code_information": [{"code": "82955", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GALACTOSE", "code_information": [{"code": "82760", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GDH ENZYME", "code_information": [{"code": "82965", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GGT", "code_information": [{"code": "82977", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GLUCAGON", "code_information": [{"code": "82943", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GLUCOSIDASE", "code_information": [{"code": "82963", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GLUTATHIONE", "code_information": [{"code": "82978", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GLYCATED PROTEIN", "code_information": [{"code": "82985", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GONADOTROPIN (FSH)", "code_information": [{"code": "83001", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF GONADOTROPIN (LH)", "code_information": [{"code": "83002", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HALOPERIDOL", "code_information": [{"code": "80173", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HAPTOGLOBIN QUANT", "code_information": [{"code": "83010", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HAPTOGLOBINS", "code_information": [{"code": "83012", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HEMOSIDERIN QUAL", "code_information": [{"code": "83070", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HISTAMINE", "code_information": [{"code": "83088", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HOMOCYSTEINE", "code_information": [{"code": "83090", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF HOMOVANILLIC ACID", "code_information": [{"code": "83150", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF IDH ENZYME", "code_information": [{"code": "83570", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF IGE", "code_information": [{"code": "82785", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF INSULIN", "code_information": [{"code": "83525", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF INSULIN", "code_information": [{"code": "83527", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF INTRINSIC FACTOR", "code_information": [{"code": "83528", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF IRON", "code_information": [{"code": "83540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF KETOGENIC STEROIDS", "code_information": [{"code": "83582", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LACTIC ACID", "code_information": [{"code": "83605", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LAP ENZYME", "code_information": [{"code": "83670", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LDH ENZYMES", "code_information": [{"code": "83625", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LEAD", "code_information": [{"code": "83655", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LIPASE", "code_information": [{"code": "83690", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LIPOPROTEIN", "code_information": [{"code": "83718", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LIPOPROTEIN(A)", "code_information": [{"code": "83695", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF LRH HORMONE", "code_information": [{"code": "83727", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF MANGANESE", "code_information": [{"code": "83785", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF MERCURY", "code_information": [{"code": "83825", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF METHEMALBUMIN", "code_information": [{"code": "83857", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF NATRIURETIC PEPTIDE", "code_information": [{"code": "83880", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF NEONATAL THYROXINE", "code_information": [{"code": "84437", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF NICKEL", "code_information": [{"code": "83885", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF NOS VITAMIN", "code_information": [{"code": "84591", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF NUCLEOTIDASE", "code_information": [{"code": "83915", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF OSTEOCALCIN", "code_information": [{"code": "83937", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF OXALATE", "code_information": [{"code": "83945", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PARATHORMONE", "code_information": [{"code": "83970", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PHENYLKETONES", "code_information": [{"code": "84035", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PHENYTOIN FREE", "code_information": [{"code": "80186", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PHENYTOIN TOTAL", "code_information": [{"code": "80185", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PORPHOBILINOGEN", "code_information": [{"code": "84110", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PREALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PREGNANEDIOL", "code_information": [{"code": "84135", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PREGNANETRIOL", "code_information": [{"code": "84138", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PREGNENOLONE", "code_information": [{"code": "84140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROCAINAMIDE", "code_information": [{"code": "80190", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROGESTERONE", "code_information": [{"code": "84234", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROINSULIN", "code_information": [{"code": "84206", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROSTAGLANDIN", "code_information": [{"code": "84150", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROTEIN ANY SOURCE", "code_information": [{"code": "84160", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROTEIN OTHER", "code_information": [{"code": "84157", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROTEIN SERUM", "code_information": [{"code": "84155", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PROTEIN URINE", "code_information": [{"code": "84156", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PSA COMPLEXED", "code_information": [{"code": "84152", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PSA FREE", "code_information": [{"code": "84154", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PSA TOTAL", "code_information": [{"code": "84153", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF PYRUVATE KINASE", "code_information": [{"code": "84220", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF QUININE", "code_information": [{"code": "84228", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF RBC GALACTOKINASE", "code_information": [{"code": "82759", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF RBC PG6D ENZYME", "code_information": [{"code": "84085", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF RENIN", "code_information": [{"code": "84244", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SEMEN FRUCTOSE", "code_information": [{"code": "82757", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SERUM ALBUMIN", "code_information": [{"code": "82040", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SERUM POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SERUM SODIUM", "code_information": [{"code": "84295", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SEX HORMONE GLOBUL", "code_information": [{"code": "84270", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SIALIC ACID", "code_information": [{"code": "84275", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SILICA", "code_information": [{"code": "84285", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SOMATOMEDIN", "code_information": [{"code": "84305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SOMATOSTATIN", "code_information": [{"code": "84307", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF SWEAT SODIUM", "code_information": [{"code": "84302", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF THIOCYANATE", "code_information": [{"code": "84430", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF THYROID (T3 OR T4)", "code_information": [{"code": "84479", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF THYROID ACTIVITY", "code_information": [{"code": "84442", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TOPIRAMATE", "code_information": [{"code": "80201", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TOTAL ESTRADIOL", "code_information": [{"code": "82670", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TOTAL TESTOSTERONE", "code_information": [{"code": "84403", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TOTAL THYROXINE", "code_information": [{"code": "84436", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TRANSCORTIN", "code_information": [{"code": "84449", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TROPONIN QUAL", "code_information": [{"code": "84512", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TROPONIN QUANT", "code_information": [{"code": "84484", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TSI GLOBULIN", "code_information": [{"code": "84445", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF TYROSINE", "code_information": [{"code": "84510", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF UREA NITROGEN", "code_information": [{"code": "84520", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE CHLORIDE", "code_information": [{"code": "82436", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE CREATININE", "code_information": [{"code": "82570", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE OSMOLALITY", "code_information": [{"code": "83935", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE PHOSPHORUS", "code_information": [{"code": "84105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE PORPHYRINS", "code_information": [{"code": "84120", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE POTASSIUM", "code_information": [{"code": "84133", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE SODIUM", "code_information": [{"code": "84300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE SULFATE", "code_information": [{"code": "84392", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE UROBILINOGEN", "code_information": [{"code": "84580", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE UROBILINOGEN", "code_information": [{"code": "84583", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE VMA", "code_information": [{"code": "84585", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE/UREA-N", "code_information": [{"code": "84540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF URINE/URIC ACID", "code_information": [{"code": "84560", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VASOPRESSIN", "code_information": [{"code": "84588", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VIP", "code_information": [{"code": "84586", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN B-1", "code_information": [{"code": "84425", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN B-2", "code_information": [{"code": "84252", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN B-6", "code_information": [{"code": "84207", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN E", "code_information": [{"code": "84446", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF VOLATILES", "code_information": [{"code": "84600", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OF ZINC", "code_information": [{"code": "84630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY OTHER FLUID CHLORIDES", "code_information": [{"code": "82438", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY PH BODY FLUID NOS", "code_information": [{"code": "83986", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY PHOSPHATIDYLGLYCEROL", "code_information": [{"code": "84081", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY PHOSPHOHEXOSE ENZYMES", "code_information": [{"code": "84087", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY PROSTATE PHOSPHATASE", "code_information": [{"code": "84066", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY RBC CHOLINESTERASE", "code_information": [{"code": "82482", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY RBC GLUTATHIONE", "code_information": [{"code": "82979", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY RBC PROTOPORPHYRIN", "code_information": [{"code": "84202", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY SERUM CHOLINESTERASE", "code_information": [{"code": "82480", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY SPEC XCP UR&BREATH IA", "code_information": [{"code": "82077", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY SYNOVIAL FLUID MUCIN", "code_information": [{"code": "83872", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY TEST FOR BLOOD FECAL", "code_information": [{"code": "82274", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY THREE CATECHOLAMINES", "code_information": [{"code": "82384", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY THYROID STIM HORMONE", "code_information": [{"code": "84443", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY TOTAL HYDROXYPROLINE", "code_information": [{"code": "83505", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY TOXIN OR ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY TRIIODOTHYRONINE (T3)", "code_information": [{"code": "84480", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSAY URINE CATECHOLAMINES", "code_information": [{"code": "82382", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSER COM TX FACE-FACE/15MIN", "code_information": [{"code": "H0039", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSERT COMM TX PGM PER DIEM", "code_information": [{"code": "H0040", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS ANGINAL SYMPTOM/LEVEL", "code_information": [{"code": "1002F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS CYST CONTRAST INJECT", "code_information": [{"code": "49424", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS DYSPNEA NOT PRESENT", "code_information": [{"code": "1018F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS DYSPNEA PRESENT", "code_information": [{"code": "1019F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS OF SALIVARY FLOW", "code_information": [{"code": "D0419", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESS VOL MGMT NOT DOC", "code_information": [{"code": "G8958", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESSMENT FOR HEARING AID", "code_information": [{"code": "V5010", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESSMENT OF A PATIENT", "code_information": [{"code": "D0191", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSESSMENT OF APHASIA", "code_information": [{"code": "96105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSIST LIVING WAIVER/DIEM", "code_information": [{"code": "T2031", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSIST LIVING WAIVER/MONTH", "code_information": [{"code": "T2030", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSIST OOCYTE FERTILIZATION", "code_information": [{"code": "89280", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSIST OOCYTE FERTILIZATION", "code_information": [{"code": "89281", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSISTIVE TECHNOLOGY ASSESS", "code_information": [{"code": "97755", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSMT & CARE PLN PT COG IMP", "code_information": [{"code": "99483", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASST OOCYTE FERT CASE RATE", "code_information": [{"code": "S4022", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSTV ALG ECG RSK ASMT CNCRT", "code_information": [{"code": "764T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASSTV ALG ECG RSK ASMT PREV", "code_information": [{"code": "765T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTH CONTROLLED", "code_information": [{"code": "G9432", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTH NOT CONTROLLED", "code_information": [{"code": "G9434", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA DISCHARGE PLAN PRESNT", "code_information": [{"code": "5250F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA EDUCATION", "code_information": [{"code": "S9441", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA IMPAIRMENT ASSESSED", "code_information": [{"code": "2015F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA KIT", "code_information": [{"code": "S8097", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA RISK ASSESSED", "code_information": [{"code": "2016F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTHMA SYMPTOMS EVALUATE", "code_information": [{"code": "1005F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTIGMATISM-CORRECT FUNCTION", "code_information": [{"code": "V2787", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTRAZENECA VACC ADM 1ST DOS", "code_information": [{"code": "D1705", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASTRAZENECA VACC ADM 2ND DOS", "code_information": [{"code": "D1706", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASXL1 FULL GENE SEQUENCE", "code_information": [{"code": "81175", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASXL1 GENE TARGET SEQ ALYS", "code_information": [{"code": "81176", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASY CARBAMAZEPIN 10,11-EPXID", "code_information": [{"code": "80161", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASY HYDROXYCORTICOSTEROIDS17", "code_information": [{"code": "83491", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASY HYDROXYPROGESTERONE 17-D", "code_information": [{"code": "83498", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASY THIOPURIN S-MTHYLTRNSFRS", "code_information": [{"code": "84433", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ASYMPT CAROT/VRTBRBAS STEN", "code_information": [{"code": "9005F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHEROSCLEROSIS WITH MCC", "code_information": [{"code": "302", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHEROSCLEROSIS WITHOUT MCC", "code_information": [{"code": "303", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHLETIC TRN EVAL HIGH CMPLX", "code_information": [{"code": "97171", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHLETIC TRN EVAL LOW CMPLX", "code_information": [{"code": "97169", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHLETIC TRN EVAL MOD CMPLX", "code_information": [{"code": "97170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATHLETIC TRN RE-EVAL PLAN CR", "code_information": [{"code": "97172", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATM MRNA SEQ ALYS", "code_information": [{"code": "136U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATN1 GENE DETC ABNOR ALLELES", "code_information": [{"code": "81177", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATOMIC ABSORPTION", "code_information": [{"code": "82190", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATROPINE COMP CON", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7635", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATROPINE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7636", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATROPINE SULFATE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0461", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTACH BLADDER/URETHRA", "code_information": [{"code": "51840", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTACH BLADDER/URETHRA", "code_information": [{"code": "51841", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTACH OCULAR IMPLANT", "code_information": [{"code": "65140", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTEMPTED VBAC AFTER CARE", "code_information": [{"code": "59622", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTEMPTED VBAC DELIVERY", "code_information": [{"code": "59618", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTEMPTED VBAC DELIVERY ONLY", "code_information": [{"code": "59620", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTENDANCE AT DELIVERY", "code_information": [{"code": "99464", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTENDANT CARE SERVICE /15M", "code_information": [{"code": "S5125", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTENDANT CARE SERVICE /DIEM", "code_information": [{"code": "S5126", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATTENDANT CONTROL", "code_information": [{"code": "E2331", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN1 GENE DETC ABNOR ALLELE", "code_information": [{"code": "81178", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN10 GENE DETC ABNOR ALLEL", "code_information": [{"code": "81183", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN2 GENE DETC ABNOR ALLELE", "code_information": [{"code": "81179", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN3 GENE DETC ABNOR ALLELE", "code_information": [{"code": "81180", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN7 GENE DETC ABNOR ALLELE", "code_information": [{"code": "81181", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ATXN8OS GEN DETC ABNOR ALLEL", "code_information": [{"code": "81182", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUD BRAINSTEM IMPLT PROGRAMG", "code_information": [{"code": "92640", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUD REHAB POSTLING HEAR LOSS", "code_information": [{"code": "92633", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUD REHAB PRE-LING HEAR LOSS", "code_information": [{"code": "92630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIO-ONLY HHS", "code_information": [{"code": "G0321", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIOLOGY SS", "code_information": [{"code": "G0062", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIOMETRY AIR & BONE", "code_information": [{"code": "209T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIOMETRY AIR & BONE", "code_information": [{"code": "92553", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIOMETRY AIR ONLY", "code_information": [{"code": "208T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIOMETRY FOR HEARING AID", "code_information": [{"code": "S0618", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIT/DAST 15-30 MIN", "code_information": [{"code": "99408", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDIT/DAST OVER 30 MIN", "code_information": [{"code": "99409", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDITORY FUNCTION + 15 MIN", "code_information": [{"code": "92621", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUDITORY FUNCTION 60 MIN", "code_information": [{"code": "92620", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUGMENTATION CHEEK BONE", "code_information": [{"code": "21270", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUGMENTATION LOWER JAW BONE", "code_information": [{"code": "21125", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUGMENTATION LOWER JAW BONE", "code_information": [{"code": "21127", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUGMENTATION OF FACIAL BONES", "code_information": [{"code": "21208", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUGMNT AI-BASED FCL PHNT A/R", "code_information": [{"code": "731T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AURIC/PERI PAIN ASSESSED", "code_information": [{"code": "1116F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AURICULAR ELECTROSTIMULATION", "code_information": [{"code": "S8930", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AURICULAR PROSTHESIS", "code_information": [{"code": "D5914", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AURICULAR REPLACEMENT", "code_information": [{"code": "D5927", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUROTHIOGLUCOSE INJECITON", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J2910", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTGRFT IMPLNT KNEE W/SCOPE", "code_information": [{"code": "29866", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO ALYS XST CT STD VRT FX", "code_information": [{"code": "691T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO CELL PROCESS SYS", "code_information": [{"code": "C1832", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO INTERM PERITONEAL DIALY", "code_information": [{"code": "E1592", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO QUAN C PLAQ CPTR ALYS", "code_information": [{"code": "625T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO QUAN C PLAQ DATA PREP", "code_information": [{"code": "624T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO QUAN C PLAQ I&R", "code_information": [{"code": "626T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO QUANTIFICATION C PLAQUE", "code_information": [{"code": "623T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO TISSUE GRAFT 1ST TOOTH", "code_information": [{"code": "D4273", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTO TISSUE GRAFT ADDL TOOTH", "code_information": [{"code": "D4283", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOCHONDROCYTE IMPLANT KNEE", "code_information": [{"code": "27412", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOIMMUNE RA ALYS 12 BMRK", "code_information": [{"code": "81490", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOL CELL IMPLT ADPS HRVG", "code_information": [{"code": "565T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOL CELL IMPLT ADPS NJX", "code_information": [{"code": "566T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOLOG PRP NOT DIAB ULCER", "code_information": [{"code": "G0460", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOLOGOUS BLOOD OP SALVAGE", "code_information": [{"code": "86891", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOLOGOUS BLOOD PROCESS", "code_information": [{"code": "86890", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC", "code_information": [{"code": "16", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC", "code_information": [{"code": "17", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATED DIFF WBC COUNT", "code_information": [{"code": "85004", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATED LEUKOCYTE COUNT", "code_information": [{"code": "85048", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATED PLATELET COUNT", "code_information": [{"code": "85049", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATED RBC COUNT", "code_information": [{"code": "85041", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATED RETICULOCYTE COUNT", "code_information": [{"code": "85045", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOMATIC BP MONITOR, DIAL", "code_information": [{"code": "A4670", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTONOMIC NRV ADRENRG INERVJ", "code_information": [{"code": "95922", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTONOMIC NRV PARASYM INERVJ", "code_information": [{"code": "95921", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTONOMIC NRV SYST FUNJ TEST", "code_information": [{"code": "95923", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) COMPLETE", "code_information": [{"code": "88020", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) COMPLETE", "code_information": [{"code": "88025", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) COMPLETE", "code_information": [{"code": "88027", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) COMPLETE", "code_information": [{"code": "88028", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) COMPLETE", "code_information": [{"code": "88029", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88000", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88005", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88007", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88012", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88014", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOPSY (NECROPSY) GROSS", "code_information": [{"code": "88016", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AUTOTRANSPLANT PARATHYROID", "code_information": [{"code": "60512", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FISTULA REVISION", "code_information": [{"code": "36833", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FISTULA REVISION OPEN", "code_information": [{"code": "36832", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FUSE UPPR ARM BASILIC", "code_information": [{"code": "36819", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FUSE UPPR ARM CEPHALIC", "code_information": [{"code": "36818", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FUSION DIRECT ANY SITE", "code_information": [{"code": "36821", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AV FUSION/FOREARM VEIN", "code_information": [{"code": "36820", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AXICABTAGENE CILOLEUCEL CAR+", "code_information": [{"code": "Q2041", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AXOLOTL AMBIENT, CRYO 0.1 MG", "code_information": [{"code": "Q4215", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AZACITIDINE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9025", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AZATHIOPRINE ORAL 50MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7500", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AZATHIOPRINE PARENTERAL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7501", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AZITHROMYCIN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0456", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AZITHROMYCIN DIHYDRATE, ORAL", "code_information": [{"code": "Q0144", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Abiomend Membrane and Abiomend Hydromembrane, per square centimeter", "code_information": [{"code": "Q4356", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Abiomend XPlus Membrane and Abiomend XPlus Hydromembrane, per square centimeter", "code_information": [{"code": "Q4355", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure)", "code_information": [{"code": "60661", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency", "code_information": [{"code": "60660", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance", "code_information": [{"code": "950T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation", "code_information": [{"code": "55881", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, includin", "code_information": [{"code": "55882", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor", "code_information": [{"code": "970T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral", "code_information": [{"code": "971T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day", "code_information": [{"code": "892T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day", "code_information": [{"code": "891T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Accelerated, repetitive high-dose 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"standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Accessory for speech generating device, electromyographic sensor", "code_information": [{"code": "E2513", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Acesso AC, per square centimeter", "code_information": [{"code": "Q4312", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Acesso, per square centimeter", "code_information": [{"code": "Q4311", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Acetylcholine receptor (AChR), antibody identification by immunofluorescence, using live cells, reported as positive or negative", "code_information": [{"code": "545U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Acute PVD", "code_information": [{"code": "M1383", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope", "code_information": [{"code": "C1606", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Add low ext mec limb vol sys", "code_information": [{"code": "L5783", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Addition endoskletl knee-shi", "code_information": [{"code": "L5841", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Addition to upper extremity prosthesis, partial hand including fingers, acrylic material", "code_information": [{"code": "L6033", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)", "code_information": [{"code": "L6032", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Addition to upper extremity, user adjustable, mechanical, residual limb volume management system", "code_information": [{"code": "L7406", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Adhesive clip ext ens contr", "code_information": [{"code": "A4438", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ASCVD) risk assessment, 5-15 minutes, not more often than every 12 months", "code_information": [{"code": "G0537", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Adult day center, 8-hour unit, for use in CMMI model", "code_information": [{"code": "G0530", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Advanced primary care management services for a patient that is a qualified Medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant ", "code_information": [{"code": "G0558", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompe", "code_information": [{"code": "G0557", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functio", "code_information": [{"code": "G0556", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AdvoGraft Dual, per square centimeter", "code_information": [{"code": "Q4382", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AdvoGraft One, per square centimeter", "code_information": [{"code": "Q4380", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AeroGuard, per square centimeter", "code_information": [{"code": "Q4370", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose", "code_information": [{"code": "Q2057", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Air polymer-type A intrauterine foam, per study dose", "code_information": [{"code": "S4024", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "All patients who were diagnosed with recurrent melanoma during the current performance period", "code_information": [{"code": "M1391", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmchoPlast Excel, per square centimeter", "code_information": [{"code": "Q4372", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmchoPlast, per square centimeter", "code_information": [{"code": "Q4316", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmchoThick, per square centimeter", "code_information": [{"code": "Q4368", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amchoplast FD, per square centimeter", "code_information": [{"code": "Q4360", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amer am ac tri-lay per sq cm", "code_information": [{"code": "Q4305", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Americ amnion ac per sq cm", "code_information": [{"code": "Q4306", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "American amnion, per sq cm", "code_information": [{"code": "Q4307", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amnio Burgeon Dual-Layer Membrane, per square centimeter", "code_information": [{"code": "Q4365", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amnio Burgeon Membrane and Hydromembrane, per square centimeter", "code_information": [{"code": "Q4363", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amnio Burgeon XPlus membrane and XPlus hydromembrane, per square centimeter", "code_information": [{"code": "Q4364", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmnioCore SL, per square centimeter", "code_information": [{"code": "Q4367", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmnioDefend FT Matrix, per square centimeter", "code_information": [{"code": "Q4379", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmnioPlast 3, per square centimeter", "code_information": [{"code": "Q4369", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "AmnioTX, per square centimeter", "code_information": [{"code": "Q4324", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amnioplast 1, per square centimeter", "code_information": [{"code": "Q4334", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Amnioplast 2, per square centimeter", "code_information": [{"code": "Q4335", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance period", "code_information": [{"code": "M1374", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance period", "code_information": [{"code": "M1375", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance period", "code_information": [{"code": "M1376", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf", "code_information": [{"code": "L1933", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf", "code_information": [{"code": "L1952", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Anoscopy with directed submucosal injection of bulking agent into anal canal", "code_information": [{"code": "963T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (", "code_information": [{"code": "15018", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less", "code_information": [{"code": "15017", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (List separately in addition to code for primary procedure)", "code_information": [{"code": "15016", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less", "code_information": [{"code": "15015", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "ArdeoGraft, per square centimeter", "code_information": [{"code": "Q4333", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Artacent C, per square centimeter", "code_information": [{"code": "Q4336", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Artacent Trident, per square centimeter", "code_information": [{"code": "Q4337", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Artacent Velos, per square centimeter", "code_information": [{"code": "Q4338", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Artacent VeriClen, per square centimeter", "code_information": [{"code": "Q4339", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed", "code_information": [{"code": "25448", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Artificial saliva, 1 ml", "code_information": [{"code": "A9154", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health ", "code_information": [{"code": "962T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report", "code_information": [{"code": "972T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Atherosclerotic cardiovascular disease (ASCVD) risk management services; clinical staff time; per calendar month", "code_information": [{"code": "G0538", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent CT examination of the same structure", "code_information": [{"code": "878T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent CT examination of any structure contained in previously acquired diagno", "code_information": [{"code": "877T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report", "code_information": [{"code": "880T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Augmentative analysis of chest computed tomography (CT) imaging data to provide 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billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic risk score for current disease activity", "code_information": [{"code": "446U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic prognostic risk score for developing a clinical flare", "code_information": [{"code": "447U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Autoinflammatory disease (VEXAS syndrome), DNA, UBA1 gene mutations, targeted variant analysis (M41T, M41V, M41L, c.118-2A>C, c.118-1G>C, c.118-9_118-2del, S56F, S621C)", "code_information": [{"code": "500U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Axolotl DualGraft, per square centimeter", "code_information": [{"code": "Q4332", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "Axolotl Graft, per square centimeter", "code_information": [{"code": "Q4331", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B BRGDRFERI ANTB 12 PRTN IGG", "code_information": [{"code": "42U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B BRGDRFERI ANTB 5 PRTN IGM", "code_information": [{"code": "41U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B BRGDRFERI LYME DS OSPA EVL", "code_information": [{"code": "316U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B CELLS TOTAL COUNT", "code_information": [{"code": "86355", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B-12 BINDING CAPACITY", "code_information": [{"code": "82608", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 MATRL QUAL TST MCRIND TIB", "code_information": [{"code": "547T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR & FX RSK ANALYSIS", "code_information": [{"code": "554T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR & FX RSK ASSESSMENT", "code_information": [{"code": "556T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR & FX RSK I&R", "code_information": [{"code": "557T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR & FX RSK VRT FX ASSMT", "code_information": [{"code": "743T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR&FX RSK ASMT DXRBMD1VW", "code_information": [{"code": "750T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR&FX RSK ASSMT DXR-BMD", "code_information": [{"code": "749T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "B1 STR&FX RSK TRANSMIS DATA", "code_information": [{"code": "555T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BABESIA MICROTI AMP PRB", "code_information": [{"code": "87469", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC", "code_information": [{"code": "519", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"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", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC", "code_information": [{"code": "520", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACK SCHOOL VISIT", "code_information": [{"code": "S9117", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACLOFEN 10 MG INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0475", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACLOFEN INTRATHECAL TRIAL", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0476", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC", "code_information": [{"code": "95", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC", "code_information": [{"code": "94", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC", "code_information": [{"code": "96", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACTERICIDAL LEVEL SERUM", "code_information": [{"code": "87197", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BACTERIUM ANTIBODY", "code_information": [{"code": "86609", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BALLISTOCARDIOGRAM", "code_information": [{"code": "S3902", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BALLOON DILATE URTRL STRIX", "code_information": [{"code": "50706", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BALO ANGIOP CTR DIALYSIS SEG", "code_information": [{"code": "36907", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BAND STABILIZATION PER TOOTH", "code_information": [{"code": "D2976", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARIUM SWALLOW TEST NOT REQ", "code_information": [{"code": "3200F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARIUM SWALLOW TEST ORDERED", "code_information": [{"code": "3142F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARRERA SLOR DL PER SQ CM", "code_information": [{"code": "Q4281", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARTONELLA ANTIBODY", "code_information": [{"code": "86611", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARTONELLA DNA AMP PROBE", "code_information": [{"code": "87471", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BARTONELLA DNA QUANT", "code_information": [{"code": "87472", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASELIN FLO CYTOMETRY B/4 TX", "code_information": [{"code": "3170F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASELINE MRS > 2", "code_information": [{"code": "M1236", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASIC LIFE DISABILITY EXAM", "code_information": [{"code": "99450", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASIC LIFE SUPPORT MILEAGE", "code_information": [{"code": "A0380", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASIC SUPPORT ROUTINE SUPPLS", "code_information": [{"code": "A0382", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASIC VESTIBULAR EVALUATION", "code_information": [{"code": "92540", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BASILIXIMAB", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0480", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATH CONDUCTIVITY METER", "code_information": [{"code": "E1550", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATH TUB RAIL FLOOR", "code_information": [{"code": "E0242", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATH TUB WALL RAIL", "code_information": [{"code": "E0241", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATH/SHOWER CHAIR", "code_information": [{"code": "E0240", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATT PACK/CART, PORT CONC", "code_information": [{"code": "E1356", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATTERY CABLES", "code_information": [{"code": "A4612", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATTERY CHARGER", "code_information": [{"code": "A4613", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATTERY CHARGER, PORT CONC", "code_information": [{"code": "E1357", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BATTERY FOR HEARING DEVICE", "code_information": [{"code": "V5266", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCAT1&IKZF1 PRMTR MTHYLN ALY", "code_information": [{"code": "229U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCG LIVE INTRAVESICAL 1MG", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9030", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCG VACCINE INTRAVESICAL", "code_information": [{"code": "90586", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCG VACCINE PERCUT", "code_information": [{"code": "90585", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCKDHB GENE", "code_information": [{"code": "81205", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCR/ABL1 GENE MAJOR BP", "code_information": [{"code": "81206", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCR/ABL1 GENE MAJOR BP QUAN", "code_information": [{"code": "40U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCR/ABL1 GENE MINOR BP", "code_information": [{"code": "81207", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BCR/ABL1 GENE OTHER BP", "code_information": [{"code": "81208", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BDY SRF MPG PM/CVDFB TM IMPL", "code_information": [{"code": "695T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BDY SURF MAPG PM/CVDFB F/UP", "code_information": [{"code": "696T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BECAPLERMIN GEL 1%, 0.5 GM", "code_information": [{"code": "S0157", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BECLOMETHASONE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7622", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BED ACCESSORY BRD/TBL/SUPPRT", "code_information": [{"code": "E0315", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BED BOARD", "code_information": [{"code": "E0273", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAV CHNG SMOKING 3-10 MIN", "code_information": [{"code": "99406", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAV CHNG SMOKING > 10 MIN", "code_information": [{"code": "99407", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAV HLTH DAY TREAT, PER HR", "code_information": [{"code": "H2012", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAVIOR COUNSEL OBESITY 15M", "code_information": [{"code": "G0447", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAVIOR MANAGEMENT", "code_information": [{"code": "D9920", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAVIORAL AND DEVELOPMENTAL DISORDERS", "code_information": [{"code": "886", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHAVRAL QUALIT ANALYS VOICE", "code_information": [{"code": "92524", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHIND EAR BINAUR HEARING AI", "code_information": [{"code": "V5140", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEHIND EAR HEARING AID", "code_information": [{"code": "V5060", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BELATACEPT INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0485", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BELIMUMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0490", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BELLACELL HD, SUREDERM SQ CM", "code_information": [{"code": "Q4220", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BELOW KNEE SURGICAL STOCKING", "code_information": [{"code": "A4500", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BELT STRAP SLEEV GRMNT COVER", "code_information": [{"code": "A4467", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENEF REFUSES SERVICE, MOD", "code_information": [{"code": "G2022", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENESCH BOOT PAIR CHILD", "code_information": [{"code": "L3213", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENESCH BOOT PAIR INFANT", "code_information": [{"code": "L3212", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENESCH BOOT PAIR JUNIOR", "code_information": [{"code": "L3214", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENIGN PROSTATIC HYPERTROPHY WITH MCC", "code_information": [{"code": "725", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC", "code_information": [{"code": "726", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES 13 OR MORE", "code_information": [{"code": "80347", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BENZODIAZEPINES1-12", "code_information": [{"code": "80346", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEST PCT PT SAFETY EM MVP", "code_information": [{"code": "G0057", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA BLCKR ADMIN W/IN 24 HRS", "code_information": [{"code": "4115F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA NOT GIVEN NO REASON", "code_information": [{"code": "G9188", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA PRES OR ALREADY TAKING", "code_information": [{"code": "G9189", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA-2 GLYCOPROTEIN ANTIBODY", "code_information": [{"code": "86146", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA-BLOC RX PT W/ABN LVEF", "code_information": [{"code": "G8450", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETA-BLOCKER THERAPY RXD/TKN", "code_information": [{"code": "4008F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETADINE/IODINE SWABS/WIPES", "code_information": [{"code": "A4247", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETADINE/PHISOHEX SOLUTION", "code_information": [{"code": "A4246", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETAMETHASONE ACET&SOD PHOSP", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0702", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETAMETHASONE COMP UNIT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7624", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BETHANECHOL CHLORIDE INJECT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0520", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEVACIZUMAB INJECTION", "code_information": [{"code": "C9257", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEVACIZUMAB INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9035", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BEXSERO-MENINGOCOCCAL 0.5", "drug_information": {"unit": 1.0, "type": "UN"}, "code_information": [{"code": "90620", "type": "CPT"}, {"code": "4719876", "type": "CDM"}, {"code": "46028011401", "type": "NDC"}, {"code": "250", "type": "RC"}], "standard_charges": [{"minimum": 318.0, "maximum": 594.0, "gross_charge": 600.0, "discounted_cash": 600.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 318.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 594.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 540.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 534.6, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 510.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 318.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 510.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 318.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "BFB TRAINING 1ST 15 MIN", "code_information": [{"code": "90912", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BFB TRAINING EA ADDL 15 MIN", "code_information": [{"code": "90913", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BH LTC RES R&B, PER DIEM", "code_information": [{"code": "T2048", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BHV ID ASSMT BY PHYS/QHP", "code_information": [{"code": "97151", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BHV ID SUPRT ASSMT BY 1 TECH", "code_information": [{"code": "97152", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BHV ID SUPRT ASSMT EA 15 MIN", "code_information": [{"code": "362T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIA WHOLE BODY", "code_information": [{"code": "358T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BICARBONATE CONC POW PER PAC", "code_information": [{"code": "A4707", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BICARBONATE CONC SOL PER GAL", "code_information": [{"code": "A4706", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIFOC PRSCP LENS", "code_information": [{"code": "S0506", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIL HKAF PC S/D MICRO SENSOR", "code_information": [{"code": "K1007", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILAT DIL RETINAL EXAM", "code_information": [{"code": "S3000", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILAT MAST/HX BI /UNILAT MAS", "code_information": [{"code": "G9708", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILAT MAST/HX BI /UNILAT MAS", "code_information": [{"code": "M1280", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC", "code_information": [{"code": "461", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC", "code_information": [{"code": "462", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILE ACIDS CHOLYLGLYCINE", "code_information": [{"code": "82240", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILE ACIDS TOTAL", "code_information": [{"code": "82239", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILE DUCT ENDOSCOPY ADD-ON", "code_information": [{"code": "47550", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILE DUCT REVISION", "code_information": [{"code": "47701", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY ENDO PERQ DX W/SPECI", "code_information": [{"code": "47552", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY ENDOSCOPY THRU SKIN", "code_information": [{"code": "47553", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY ENDOSCOPY THRU SKIN", "code_information": [{"code": "47554", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY ENDOSCOPY THRU SKIN", "code_information": [{"code": "47555", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY ENDOSCOPY THRU SKIN", "code_information": [{"code": "47556", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC", "code_information": [{"code": "409", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC", "code_information": [{"code": "408", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC", "code_information": [{"code": "410", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIRUBIN DIRECT", "code_information": [{"code": "82248", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL", "code_information": [{"code": "82247", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILIRUBIN TOTAL TRANSCUT", "code_information": [{"code": "88720", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BILOBECTOMY", "code_information": [{"code": "32482", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIMALEOLAR FX ANKLE CL TX", "code_information": [{"code": "27810", "type": "CPT"}, {"code": "4003195", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"minimum": 1484.0, "maximum": 2772.0, "gross_charge": 2800.0, "discounted_cash": 2800.0, "setting": "both", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "standard_charge_dollar": 1484.0, "methodology": "fee schedule"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "standard_charge_dollar": 2772.0, "methodology": "fee schedule"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "standard_charge_dollar": 2520.0, "methodology": "fee schedule"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "standard_charge_dollar": 2494.8, "methodology": "fee schedule"}, {"payer_name": "Cigna", "plan_name": "Commercial", "standard_charge_dollar": 2380.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "standard_charge_dollar": 1484.0, "methodology": "fee schedule"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "standard_charge_dollar": 2380.0, "methodology": "fee schedule"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "standard_charge_dollar": 1484.0, "methodology": "fee schedule"}], "billing_class": "facility"}]}, {"description": "BIO MTRLS TO AID SOFT/OS REG", "code_information": [{"code": "D4265", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIO-CONNEKT PER SQUARE CM", "code_information": [{"code": "Q4161", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIODFENCE 1CM", "code_information": [{"code": "Q4140", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIODFENCE DRYFLEX, 1CM", "code_information": [{"code": "Q4138", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOFEEDBACK TRAIN ANY METH", "code_information": [{"code": "90901", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOIMPEDANCE CV ANALYSIS", "code_information": [{"code": "93701", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOLOGICAL MATERIALS", "code_information": [{"code": "D3431", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC", "code_information": [{"code": "478", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC", "code_information": [{"code": "477", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC", "code_information": [{"code": "479", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY ABDOMINAL MASS", "code_information": [{"code": "49180", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY ARM/ELBOW SOFT TISSUE", "code_information": [{"code": "24065", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY ARM/ELBOW SOFT TISSUE", "code_information": [{"code": "24066", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY EYE MUSCLE", "code_information": [{"code": "67346", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY EYELID & LID MARGIN", "code_information": [{"code": "67810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY FINGER JOINT LINING", "code_information": [{"code": "26105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY FINGER JOINT LINING", "code_information": [{"code": "26110", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY FOREARM SOFT TISSUES", "code_information": [{"code": "25065", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY FOREARM SOFT TISSUES", "code_information": [{"code": "25066", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY HAND JOINT LINING", "code_information": [{"code": "26100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY KNEE JOINT LINING", "code_information": [{"code": "27330", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY LOWER LEG SOFT TISSUE", "code_information": [{"code": "27613", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY LOWER LEG SOFT TISSUE", "code_information": [{"code": "27614", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY MUSCLE PERQ NEEDLE", "code_information": [{"code": "20206", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY NAIL UNIT", "code_information": [{"code": "11755", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF BOWEL", "code_information": [{"code": "44100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF BREAST OPEN", "code_information": [{"code": "19101", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF CERVIX", "code_information": [{"code": "57500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF CERVIX W/SCOPE", "code_information": [{"code": "57455", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF CORNEA", "code_information": [{"code": "65410", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF EPIDIDYMIS", "code_information": [{"code": "54800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF EXTERNAL EAR", "code_information": [{"code": "69100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF EXTERNAL EAR CANAL", "code_information": [{"code": "69105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF EYELID LINING", "code_information": [{"code": "68100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF FLOOR OF MOUTH", "code_information": [{"code": "41108", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF FOOT JOINT LINING", "code_information": [{"code": "28050", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF FOOT JOINT LINING", "code_information": [{"code": "28052", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF HEART LINING", "code_information": [{"code": "93505", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF HIP JOINT", "code_information": [{"code": "27052", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF LIP", "code_information": [{"code": "40490", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF MOUTH LESION", "code_information": [{"code": "40808", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF NECK/CHEST", "code_information": [{"code": "21550", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF NERVE", "code_information": [{"code": "64795", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF ORAL TISSUE HARD", "code_information": [{"code": "D7285", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF ORAL TISSUE SOFT", "code_information": [{"code": "D7286", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF OVARY(S)", "code_information": [{"code": "58900", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF PANCREAS OPEN", "code_information": [{"code": "48100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF PENIS", "code_information": [{"code": "54100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF PENIS", "code_information": [{"code": "54105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF PROSTATE", "code_information": [{"code": "55700", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF PROSTATE", "code_information": [{"code": "55705", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF RECTUM", "code_information": [{"code": "45100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SACROILIAC JOINT", "code_information": [{"code": "27050", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SALIVARY GLAND", "code_information": [{"code": "42400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SALIVARY GLAND", "code_information": [{"code": "42405", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SHOULDER JOINT", "code_information": [{"code": "23100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SOFT TISSUES", "code_information": [{"code": "27040", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF SOFT TISSUES", "code_information": [{"code": "27041", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF STOMACH", "code_information": [{"code": "43605", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TEAR GLAND", "code_information": [{"code": "68510", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TEAR SAC", "code_information": [{"code": "68525", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TESTIS", "code_information": [{"code": "54500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TESTIS", "code_information": [{"code": "54505", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF THROAT", "code_information": [{"code": "42800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF THYROID", "code_information": [{"code": "60100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TOE JOINT LINING", "code_information": [{"code": "28054", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TONGUE", "code_information": [{"code": "41100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF TONGUE", "code_information": [{"code": "41105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF UPPER NOSE/THROAT", "code_information": [{"code": "42804", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF UPPER NOSE/THROAT", "code_information": [{"code": "42806", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF URETHRA", "code_information": [{"code": "53200", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF UTERUS LINING", "code_information": [{"code": "58100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF VAGINA", "code_information": [{"code": "57100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF VAGINA", "code_information": [{"code": "57105", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF VULVA/PERINEUM", "code_information": [{"code": "56605", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF VULVA/PERINEUM", "code_information": [{"code": "56606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OF WRIST JOINT", "code_information": [{"code": "25100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OOCYTE POLAR BODY", "code_information": [{"code": "89291", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY OOCYTE POLAR BODY <=5", "code_information": [{"code": "89290", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY ROOF OF MOUTH", "code_information": [{"code": "42100", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY SHOULDER TISSUES", "code_information": [{"code": "23065", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY SHOULDER TISSUES", "code_information": [{"code": "23066", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY SOFT TISSUE OF BACK", "code_information": [{"code": "21920", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY SOFT TISSUE OF BACK", "code_information": [{"code": "21925", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY THIGH SOFT TISSUES", "code_information": [{"code": "27323", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY THIGH SOFT TISSUES", "code_information": [{"code": "27324", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY VRT BDY OPEN LMBR/CRV", "code_information": [{"code": "20251", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY VRT BDY OPEN THORACIC", "code_information": [{"code": "20250", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY/REMOVAL LYMPH NODES", "code_information": [{"code": "38500", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY/REMOVAL LYMPH NODES", "code_information": [{"code": "38510", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY/REMOVAL LYMPH NODES", "code_information": [{"code": "38520", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY/REMOVAL LYMPH NODES", "code_information": [{"code": "38525", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOPSY/REMOVAL LYMPH NODES", "code_information": [{"code": "38530", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOVANCE 1 SQUARE CM", "code_information": [{"code": "Q4154", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIOVANCE TRI OR 3L, SQ CM", "code_information": [{"code": "Q4283", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIPHOS THXPY VEIN ORD/RECVD", "code_information": [{"code": "4100F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIRTHING CLASS", "code_information": [{"code": "S9442", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIS XTRACELL FLUID ANALYSIS", "code_information": [{"code": "93702", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BITEWING IMAGE CAPTURE ONLY", "code_information": [{"code": "D0388", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BITEWINGS - THREE IMAGES", "code_information": [{"code": "D0273", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BITEWINGS FOUR IMAGES", "code_information": [{"code": "D0274", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BITOLTEROL MESYLATE COMP CON", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7628", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BITOLTEROL MESYLATE COMP UNT", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J7629", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BIVALIRUDIN", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0583", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK IMAGING TST NOT ORDERED", "code_information": [{"code": "3331F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN & FXN ASSESSED", "code_information": [{"code": "1130F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN NO VAS", "code_information": [{"code": "G9946", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN VAS 6-20WK <= 3", "code_information": [{"code": "G2136", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN VAS 6-20WK > 3", "code_information": [{"code": "G2137", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN VAS 9-15MO <= 3", "code_information": [{"code": "G2138", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PAIN VAS 9-15MO > 3", "code_information": [{"code": "G2139", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PN NT MSR VAS SCL PRE/PST", "code_information": [{"code": "G9943", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BK PN XM ON INIT VISIT DATE", "code_information": [{"code": "2040F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BKBENCH PREP DON UTER ALGRFT", "code_information": [{"code": "668T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BKBENCH RCNSTJ DON UTER ARTL", "code_information": [{"code": "670T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BKBENCH RCNSTJ DON UTER VEN", "code_information": [{"code": "669T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL DONOR SEARCH MANAGEMENT", "code_information": [{"code": "38204", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL DRAW < 3 YRS FEM/JUGULAR", "code_information": [{"code": "36400", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL DRAW <3 YRS OTHER VEIN", "code_information": [{"code": "36406", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL DRAW <3 YRS SCALP VEIN", "code_information": [{"code": "36405", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL SMEAR W/DIFF WBC COUNT", "code_information": [{"code": "85007", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BL SMEAR W/O DIFF WBC COUNT", "code_information": [{"code": "85008", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLADDER CALCULI IRRIG SOL", "code_information": [{"code": "Q2004", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLASTOMYCES ANTIBODY", "code_information": [{"code": "86612", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLD EXCHANGE TRUJ NEWBORN", "code_information": [{"code": "36450", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLD EXCHANGE TRUJ OTH THN NB", "code_information": [{"code": "36455", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLD PUSH TFUJ 2 YR/<", "code_information": [{"code": "36440", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLD TYPING SEROLOGIC RH PHNT", "code_information": [{"code": "86906", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLEEDING TIME TEST", "code_information": [{"code": "85002", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLEOMYCIN SULFATE INJECTION", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9040", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLIND COR SINUS REDUCER IMPL", "code_information": [{"code": "C9783", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLIND INTERATRIAL SHUNT IDE", "code_information": [{"code": "C9758", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLIND MYOCAR TRPL BON MARROW", "code_information": [{"code": "C9782", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLIND/NONBLIND TRANS ATRIAL", "code_information": [{"code": "C9792", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLINDED CONV. TX MDD CLIN TR", "code_information": [{"code": "G2000", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLINK REFLEX TEST", "code_information": [{"code": "95933", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLM GENE", "code_information": [{"code": "81209", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOC CLOT FACTOR V TEST", "code_information": [{"code": "85220", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD CLOT LYSIS TIME", "code_information": [{"code": "85175", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD CLOT RETRACTION", "code_information": [{"code": "85170", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD COLLECTION TUBE/VACUUM", "code_information": [{"code": "A4770", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD COMPONENT/PRODUCT NOC", "code_information": [{"code": "P9099", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD CULTURE FOR BACTERIA", "code_information": [{"code": "87040", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD FUNGUS CULTURE", "code_information": [{"code": "87103", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD GASES ANY COMBINATION", "code_information": [{"code": "82803", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD GASES O2 SAT ONLY", "code_information": [{"code": "82810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD GASES W/O2 SATURATION", "code_information": [{"code": "82805", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD GLUCOSE LEVEL TEST", "code_information": [{"code": "D0412", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD GLUCOSE TEST STRIPS", "code_information": [{"code": "A4772", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD KETONE TEST OR STRIP", "code_information": [{"code": "A4252", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD MUCOPROTEIN", "code_information": [{"code": "P2038", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD PH", "code_information": [{"code": "82800", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD PLATELET AGGREGATION", "code_information": [{"code": "85576", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD PRESSURE MEASURE", "code_information": [{"code": "2000F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD PRODUCT/IRRADIATION", "code_information": [{"code": "86945", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD SMEAR INTERPRETATION", "code_information": [{"code": "85060", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD SPLIT UNIT", "code_information": [{"code": "P9011", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD THYMOL TURBIDITY", "code_information": [{"code": "P2033", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPE ANTIGEN DONOR EA", "code_information": [{"code": "86902", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING ANTIGEN SYSTEM", "code_information": [{"code": "86911", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING PATERNITY TEST", "code_information": [{"code": "86910", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING PATIENT SERUM", "code_information": [{"code": "86904", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING RBC ANTIGENS", "code_information": [{"code": "86905", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING SEROLOGIC ABO", "code_information": [{"code": "86900", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD TYPING SEROLOGIC RH(D)", "code_information": [{"code": "86901", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD VISCOSITY EXAMINATION", "code_information": [{"code": "85810", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD VOLUME", "code_information": [{"code": "78122", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD, L/R, CMV-NEG", "code_information": [{"code": "P9051", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD, L/R, FROZ/DEGLY/WASH", "code_information": [{"code": "P9054", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLOOD, L/R, IRRADIATED", "code_information": [{"code": "P9056", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLS", "code_information": [{"code": "A0428", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLS DEFIBRILLATION SUPPLIES", "code_information": [{"code": "A0384", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLS-EMERGENCY", "code_information": [{"code": "A0429", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BLUE LIGHT CYSTO IMAG AGENT", "code_information": [{"code": "C9738", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI DOC ONL FUP NOT CMPLTD", "code_information": [{"code": "G9716", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI DOC ONL FUP NOT CMPLTD", "code_information": [{"code": "M1286", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI NOT CALCULATED", "code_information": [{"code": "G8421", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI NOT CALCULATED", "code_information": [{"code": "M1314", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI NOT DOC MEDRSN PTREF", "code_information": [{"code": "G2181", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMI NOT DOC MEDRSN PTREF", "code_information": [{"code": "M1297", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BMT HARV/TRANSPL 28D PKG", "code_information": [{"code": "S2150", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BN DEN 2YR/GOT OST MED/THER", "code_information": [{"code": "G9769", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY FLUID CELL COUNT", "code_information": [{"code": "89050", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY FLUID CELL COUNT", "code_information": [{"code": "89051", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY FLUID SPECIFIC GRAVITY", "code_information": [{"code": "84315", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY MASS INDEX DOCD", "code_information": [{"code": "3008F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY-WORN BILAT HEARING AID", "code_information": [{"code": "V5100", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY-WORN BINAUR HEARING AID", "code_information": [{"code": "V5120", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY-WORN HEARING AID AIR", "code_information": [{"code": "V5030", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BODY-WORN HEARING AID BONE", "code_information": [{"code": "V5040", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE BIOPSY OPEN DEEP", "code_information": [{"code": "20245", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE BIOPSY OPEN SUPERFICIAL", "code_information": [{"code": "20240", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE BIOPSY TROCAR/NDL DEEP", "code_information": [{"code": "20225", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE BIOPSY TROCAR/NDL SUPFC", "code_information": [{"code": "20220", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE CUTTING BODY MANDIBLE", "code_information": [{"code": "D7945", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE CUTTING RAMUS CLOSED", "code_information": [{"code": "D7941", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE CUTTING SEGMENTED", "code_information": [{"code": "D7944", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE DISEASES AND ARTHROPATHIES WITH MCC", "code_information": [{"code": "553", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE DISEASES AND ARTHROPATHIES WITHOUT MCC", "code_information": [{"code": "554", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE GRAFT PERI EACH ADDL", "code_information": [{"code": "D3429", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE GRAFT PERI PER TOOTH", "code_information": [{"code": "D3428", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE GRAFT REPAIR PERIMPLANT", "code_information": [{"code": "D6103", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE GRAFT TIME OF IMPLANT", "code_information": [{"code": "D6104", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE HARVEST,AUTO GRAFT PROC", "code_information": [{"code": "D7295", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE IMAGING 3 PHASE", "code_information": [{"code": "78315", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE IMAGING LIMITED AREA", "code_information": [{"code": "78300", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE IMAGING MULTIPLE AREAS", "code_information": [{"code": "78305", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE IMAGING WHOLE BODY", "code_information": [{"code": "78306", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW ASPIR BONE GRFG", "code_information": [{"code": "20939", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW HARVEST ALLOGEN", "code_information": [{"code": "38230", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW HARVEST AUTOLOG", "code_information": [{"code": "38232", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW IMAGING BODY", "code_information": [{"code": "78104", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW IMAGING LTD", "code_information": [{"code": "78102", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW IMAGING MULT", "code_information": [{"code": "78103", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MARROW INTERPRETATION", "code_information": [{"code": "85097", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MINERAL DUAL PHOTON", "code_information": [{"code": "78351", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE MINERAL SINGLE PHOTON", "code_information": [{"code": "78350", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE REPLACEMENT GRAFT", "code_information": [{"code": "D7953", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE REPLCE GRAFT EACH ADD", "code_information": [{"code": "D4264", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE REPLCE GRAFT FIRST SITE", "code_information": [{"code": "D4263", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE SCN B/4 TXMNT/AFTR DX", "code_information": [{"code": "3269F", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE SRGRY CMPTR CT/MRI IMAG", "code_information": [{"code": "55T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE SRGRY CMPTR FLUOR IMAGE", "code_information": [{"code": "54T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE/SKIN GRAFT GREAT TOE", "code_information": [{"code": "20973", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE/SKIN GRAFT ILIAC CREST", "code_information": [{"code": "20970", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE/SKIN GRAFT METATARSAL", "code_information": [{"code": "20972", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BONE/SKIN GRAFT MICROVASC", "code_information": [{"code": "20969", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BORDETELLA ANTIBODY", "code_information": [{"code": "86615", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BORRELIA ANTIBODY", "code_information": [{"code": "86619", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BORRELIA MIYAMOTOI AMP PRB", "code_information": [{"code": "87478", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BOTULINUM ANTITOXIN", "code_information": [{"code": "90287", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BOTULISM IG IV", "code_information": [{"code": "90288", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BOWEL TO BOWEL FUSION", "code_information": [{"code": "44130", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP NOT PERFORMED/DOC", "code_information": [{"code": "G8478", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP OUT OF NRML LIMITS", "code_information": [{"code": "G9274", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SCRN NO PERF AT INTERVAL", "code_information": [{"code": "G8785", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SCRN NO PERF AT INTERVAL", "code_information": [{"code": "M1281", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SCRN PERF REC INTERVAL", "code_information": [{"code": "G8783", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SCRN PERF REC INTERVAL", "code_information": [{"code": "M1294", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SYS <140 AND DIAS <90", "code_information": [{"code": "G8476", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BP SYS>=140 AND/OR DIAS >=90", "code_information": [{"code": "G8477", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BPCI ADVANCED IN HOME VISIT", "code_information": [{"code": "G9987", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BPCI HOME VISIT", "code_information": [{"code": "G9187", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHY LINEAR, NON-STR,P-103", "code_information": [{"code": "C2636", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHY,NON-STR,YTTERBIUM-169", "code_information": [{"code": "C2637", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTHERAPY NEEDLE", "code_information": [{"code": "C1715", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTHERAPY RADIOELEMENTS", "code_information": [{"code": "Q3001", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX CESIUM-131 CHLORIDE", "code_information": [{"code": "C2644", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX ISODOSE COMPLEX", "code_information": [{"code": "77318", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX ISODOSE INTERMED", "code_information": [{"code": "77317", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX ISODOSE PLAN SIMPLE", "code_information": [{"code": "77316", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX PLANAR, P-103", "code_information": [{"code": "C2645", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STR, GOLD-198", "code_information": [{"code": "C1716", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STR, HA, I-125", "code_information": [{"code": "C2634", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STR, HA, P-103", "code_information": [{"code": "C2635", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STR,HDR IR-192", "code_information": [{"code": "C1717", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STR,YTTRIUM-90", "code_information": [{"code": "C2616", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STRANDED, NOS", "code_information": [{"code": "C2699", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STRANDED,C-131", "code_information": [{"code": "C2643", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STRANDED,I-125", "code_information": [{"code": "C2639", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NON-STRANDED,P-103", "code_information": [{"code": "C2641", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, NS, NON-HDRIR-192", "code_information": [{"code": "C1719", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, STRANDED, C-131", "code_information": [{"code": "C2642", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, STRANDED, I-125", "code_information": [{"code": "C2638", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, STRANDED, NOS", "code_information": [{"code": "C2698", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRACHYTX, STRANDED, P-103", "code_information": [{"code": "C2640", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAF GENE", "code_information": [{"code": "81210", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN ANEURYSM REPR COMPLX", "code_information": [{"code": "61697", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN ANEURYSM REPR COMPLX", "code_information": [{"code": "61698", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN ANEURYSM REPR SIMPLE", "code_information": [{"code": "61700", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN BIOPSY W/CT/MR GUIDE", "code_information": [{"code": "61751", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN CANAL SHUNT PROCEDURE", "code_information": [{"code": "61070", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN CAVITY SHUNT W/SCOPE", "code_information": [{"code": "62201", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN FLOW IMAGING ONLY", "code_information": [{"code": "78610", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGE 4+ VIEWS", "code_information": [{"code": "78605", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGE < 4 VIEWS", "code_information": [{"code": "78600", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGE W/FLOW 4 + VIEWS", "code_information": [{"code": "78606", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGE W/FLOW < 4 VIEWS", "code_information": [{"code": "78601", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGING (PET)", "code_information": [{"code": "78608", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRAIN IMAGING (PET)", "code_information": [{"code": "78609", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1 BRCA2 MRNA SEQ ALYS", "code_information": [{"code": "138U", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1 GENE FULL DUP/DEL ALYS", "code_information": [{"code": "81166", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1 GENE FULL SEQ ALYS", "code_information": [{"code": "81165", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1 GENE KNOWN FAMIL VRNT", "code_information": [{"code": "81215", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1&2 185&5385&6174 VRNT", "code_information": [{"code": "81212", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1&2 GEN FUL DUP/DEL ALYS", "code_information": [{"code": "81164", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1&2 GEN FULL SEQ DUP/DEL", "code_information": [{"code": "81162", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA1&2 GENE FULL SEQ ALYS", "code_information": [{"code": "81163", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA2 GENE FULL DUP/DEL ALYS", "code_information": [{"code": "81167", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA2 GENE FULL SEQ ALYS", "code_information": [{"code": "81216", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRCA2 GENE KNOWN FAMIL VRNT", "code_information": [{"code": "81217", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST \"\"STACKED\"\" DIEP/GAP", "code_information": [{"code": "S2067", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST AUGMENTATION W/IMPLT", "code_information": [{"code": "19325", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC", "code_information": [{"code": "584", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC", "code_information": [{"code": "585", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST CANCER DX MIN INVSIVE", "code_information": [{"code": "G8875", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST DIEP OR SIEA FLAP", "code_information": [{"code": "S2068", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST GAP FLAP RECONST", "code_information": [{"code": "S2066", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST MILK PROC/STORE/DIST", "code_information": [{"code": "T2101", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST PROSTHESIS NOS", "code_information": [{"code": "L8039", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST RECONSTRUCTION", "code_information": [{"code": "19350", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST REDUCTION", "code_information": [{"code": "19318", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST TOMOSYNTHESIS BI", "code_information": [{"code": "77062", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST TOMOSYNTHESIS BI", "code_information": [{"code": "77063", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREAST TOMOSYNTHESIS UNI", "code_information": [{"code": "77061", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREATH HYDROGEN/METHANE TEST", "code_information": [{"code": "91065", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREATH RECORDING INFANT", "code_information": [{"code": "94772", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREATH TEST ANALYSIS C-14", "code_information": [{"code": "78268", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREATH TST ATTAIN/ANAL C-14", "code_information": [{"code": "78267", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREATHING CAPACITY TEST", "code_information": [{"code": "94010", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRENTUXIMAB VEDOTIN INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J9042", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BREXUCABTAGENE CAR POS T", "code_information": [{"code": "Q2053", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE BASE METAL CAST", "code_information": [{"code": "D6211", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE NOBLE METAL CAST", "code_information": [{"code": "D6212", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE PORCELAIN BASE METAL", "code_information": [{"code": "D6241", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE PORCELAIN HIGH NOBLE", "code_information": [{"code": "D6240", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE PORCELAIN NOBEL METAL", "code_information": [{"code": "D6242", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE PORCELAIN/CERAMIC", "code_information": [{"code": "D6245", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE RESIN BASE METAL", "code_information": [{"code": "D6251", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE RESIN W/HIGH NOBLE", "code_information": [{"code": "D6250", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIDGE RESIN W/NOBLE METAL", "code_information": [{"code": "D6252", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIEF ALCOHOL MISUSE COUNSEL", "code_information": [{"code": "G0443", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIEF CHKIN BY MD/QHP, 11-20", "code_information": [{"code": "G2252", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIEF CHKIN, 5-10, NON-E/M", "code_information": [{"code": "G2251", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRIEF EMOTIONAL/BEHAV ASSMT", "code_information": [{"code": "96127", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRNCHSC RF DSTRJ PLM NRV UNI", "code_information": [{"code": "782T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRNCHSC RF DSTRJ PULM NRV BI", "code_information": [{"code": "781T", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRNCHSC W/THER ASPIR 1ST", "code_information": [{"code": "31645", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRNCHSC W/THER ASPIR SBSQ", "code_information": [{"code": "31646", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BROMPHENIRAMINE MALEATE INJ", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "J0945", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH EBUS IVNTJ PERPH LES", "code_information": [{"code": "31654", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH EBUS SAMPLNG 1/2 NODE", "code_information": [{"code": "31652", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH EBUS SAMPLNG 3/> NODE", "code_information": [{"code": "31653", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH LAVAGE W/EBUS", "code_information": [{"code": "C7556", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH THERMOPLSTY 1 LOBE", "code_information": [{"code": "31660", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH THERMOPLSTY 2/> LOBES", "code_information": [{"code": "31661", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH W RX ANTIBX 30D", "code_information": [{"code": "G2177", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH W/BALLOON OCCLUSION", "code_information": [{"code": "31634", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH/BPSY(S) W/ EBUS", "code_information": [{"code": "C7512", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH/BPSY(S) W/ NAVIGATION", "code_information": [{"code": "C7511", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCH/LAVAG W/ NAVIGATION", "code_information": [{"code": "C7510", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL ALLERGY TESTS", "code_information": [{"code": "95070", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL BRUSH BIOPSY", "code_information": [{"code": "31717", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL VALVE ADDL INSERT", "code_information": [{"code": "31651", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL VALVE INIT INSERT", "code_information": [{"code": "31647", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL VALVE REMOV ADDL", "code_information": [{"code": "31649", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHIAL VALVE REMOV INIT", "code_information": [{"code": "31648", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHITIS AND ASTHMA WITH CC/MCC", "code_information": [{"code": "202", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHITIS AND ASTHMA WITHOUT CC/MCC", "code_information": [{"code": "203", "type": "MS-DRG"}], "standard_charges": [{"setting": "inpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 96.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY BRONCH STENTS", "code_information": [{"code": "31636", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DILATE W/STENT", "code_information": [{"code": "31631", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY DILATE/FX REPR", "code_information": [{"code": "31630", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY REVISE STENT", "code_information": [{"code": "31638", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY STENT ADD-ON", "code_information": [{"code": "31637", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY TREAT BLOCKAGE", "code_information": [{"code": "31641", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W/BIOPSY(S)", "code_information": [{"code": "31625", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W/FB REMOVAL", "code_information": [{"code": "31635", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W/MARKERS", "code_information": [{"code": "31626", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY W/TUMOR EXCISE", "code_information": [{"code": "31640", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY/LUNG BX ADDL", "code_information": [{"code": "31632", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY/LUNG BX EACH", "code_information": [{"code": "31628", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY/NEEDLE BX ADDL", "code_information": [{"code": "31633", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRONCHOSCOPY/NEEDLE BX EACH", "code_information": [{"code": "31629", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST CNCR STAGE > T1N0M0", "code_information": [{"code": "G8881", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST RCNSTJ 1 PDCL TRAM FLAP", "code_information": [{"code": "19367", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST RCNSTJ 1PDCL TRAM ANAST", "code_information": [{"code": "19368", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST RCNSTJ 2 PDCL TRAM FLAP", "code_information": [{"code": "19369", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST RCNSTJ FREE FLAP", "code_information": [{"code": "19364", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRST RCNSTJ LATSMS DRSI FLAP", "code_information": [{"code": "19361", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRT CA DX I, NO T1/T1A/T1B", "code_information": [{"code": "G9832", "type": "HCPCS"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Kaiser South", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}], "billing_class": "facility"}]}, {"description": "BRUCELLA ANTIBODY", "code_information": [{"code": "86622", "type": "CPT"}], "standard_charges": [{"setting": "outpatient", "payers_information": [{"payer_name": "Anthem", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Anthem Blue Cross", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 99.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Cross California Exchange", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 90.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Blue Shield of California", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 89.1, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "Cigna", "plan_name": "Commercial", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 85.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet", "plan_name": "Medi-Cal", "additional_payer_notes": "No historical data found for payer/plan and coding combination", "standard_charge_percentage": 53.0, "count": "0", "methodology": "percent of total billed charges"}, {"payer_name": "HealthNet Covered California", "plan_name": "Commercial", "additional_payer_notes": "No histo