{"hospital_name": "Arizona Spine and Joint Hospital LLC", "last_updated_on": "2026-04-14", "version": "3.0.0", "pid": "2095547270", "rid": "12448", "location_name": ["Arizona Spine and Joint Hospital"], "hospital_address": ["4620 E Baseline Rd, Mesa, AZ 85206"], "type_2_npi": ["1396745832"], "license_information": {"license_number": "SH3711", "state": "AZ"}, "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": "Geoffrey Vines"}, "standard_charge_information": [{"description": "ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY", "code_information": [{"code": "770", "type": "MS-DRG"}], "standard_charges": [{"minimum": 8624.36, "maximum": 16684.04, "discounted_cash": 5844.75, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 16684.04, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 10605.14, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 8624.36, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 10605.14, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 13814.32, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ABORTION WITHOUT D&C", "code_information": [{"code": "779", "type": "MS-DRG"}], "standard_charges": [{"minimum": 10681.38, "maximum": 20663.4, "discounted_cash": 7238.8, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 20663.4, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 13134.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 10681.38, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 13134.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 17109.2, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ABS TRANSFER BAG", "code_information": [{"code": "2700001913", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 17.66, "setting": "both", "billing_class": "facility"}]}, {"description": "ACE DRESSING 2IN STERILE", "code_information": [{"code": "2700001093", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 10.59, "setting": "both", "billing_class": "facility"}]}, {"description": "ACE DRESSING 3IN STERILE", "code_information": [{"code": "2700001094", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 11.77, "setting": "both", "billing_class": "facility"}]}, {"description": "ACE DRESSING 6IN STERILE", "code_information": [{"code": "2700001096", "type": "CDM"}, {"code": "270", "type": "RC"}], "standard_charges": [{"gross_charge": 11.77, "setting": "both", "billing_class": "facility"}]}, {"description": "ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION", "code_information": [{"code": "880", "type": "MS-DRG"}], "standard_charges": [{"minimum": 10307.77, "maximum": 19940.64, "discounted_cash": 6985.6, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 19940.64, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 12675.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 10307.77, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 12675.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 16510.76, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITH CC", "code_information": [{"code": "289", "type": "MS-DRG"}], "standard_charges": [{"minimum": 15956.2, "maximum": 30867.68, "discounted_cash": 10813.56, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 30867.68, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 19620.9, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 15956.2, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non 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"United Healthcare", "plan_name": "Options", "standard_charge_dollar": 44848.53, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC", "code_information": [{"code": "290", "type": "MS-DRG"}], "standard_charges": [{"minimum": 11070.11, "maximum": 22666.65, "discounted_cash": 7502.24, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 22666.65, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 13612.61, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 11070.11, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 13612.61, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 17731.86, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}], "standard_charges": [{"minimum": 42.87, "maximum": 805.29, "discounted_cash": 47.63, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 805.29, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 42.87, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 42.87, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 42.87, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 42.87, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH CC", "code_information": [{"code": "835", "type": "MS-DRG"}], "standard_charges": [{"minimum": 24138.93, "maximum": 46697.36, "discounted_cash": 16359.01, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 46697.36, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 29682.97, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 24138.93, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 29682.97, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 38665.21, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITH MCC", "code_information": [{"code": "834", "type": "MS-DRG"}], "standard_charges": [{"minimum": 60458.0, "maximum": 116957.51, "discounted_cash": 40972.53, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 116957.51, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 74343.52, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 60458.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 74343.52, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 96840.3, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE LEUKEMIA WITHOUT CC/MCC", "code_information": [{"code": "836", "type": "MS-DRG"}], "standard_charges": [{"minimum": 12928.45, "maximum": 29493.18, "discounted_cash": 8761.64, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", 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{"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 17011.77, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 13834.4, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 17011.77, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 22159.64, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC", "code_information": [{"code": "122", "type": "MS-DRG"}], "standard_charges": [{"minimum": 8039.11, "maximum": 15551.86, "discounted_cash": 5448.12, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 15551.86, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 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1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC FOOT/TOE TUM SC < 1.5 CM", "code_information": [{"code": "28043", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1942.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC FOREARM TUM DEEP 3 CM/>", "code_information": [{"code": "25073", "type": "CPT"}], "standard_charges": [{"minimum": 2125.0, "maximum": 6115.0, "discounted_cash": 2815.86, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 6115.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC FOREARM TUM DEEP < 3 CM", "code_information": [{"code": "25076", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 2151.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2151.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 0.5/<", "code_information": [{"code": "11420", "type": "CPT"}], "standard_charges": [{"minimum": 952.0, "maximum": 1458.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1458.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 952.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1407.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 0.6-1", "code_information": [{"code": "11421", "type": "CPT"}], "standard_charges": [{"minimum": 952.0, "maximum": 1458.0, "discounted_cash": 697.23, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1458.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 952.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1407.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 1.1-2", "code_information": [{"code": "11422", "type": "CPT"}], "standard_charges": [{"minimum": 952.0, "maximum": 1458.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1458.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 952.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1407.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC H-F-NK-SP B9+MARG 2.1-3", "code_information": [{"code": "11423", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1786.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1458.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC HAND LES SC 1.5 CM/>", "code_information": [{"code": "26111", "type": "CPT"}], "standard_charges": [{"minimum": 2125.0, "maximum": 6115.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 6115.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC HAND LES SC < 1.5 CM", "code_information": [{"code": "26115", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1942.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC HAND TUM DEEP 1.5 CM/>", "code_information": [{"code": "26113", "type": "CPT"}], "standard_charges": [{"minimum": 2125.0, "maximum": 6115.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 6115.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC HAND TUM DEEP < 1.5 CM", "code_information": [{"code": "26116", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1942.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC LEG/ANKLE TUM < 3 CM", "code_information": [{"code": "27618", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1942.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": 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"plan_name": "Non Options", "standard_charge_dollar": 1081.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1407.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC SHOULDER LES SC < 3 CM", "code_information": [{"code": "23075", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 1942.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "EXC THIGH/KNEE LES SC < 3 CM", "code_information": [{"code": "27327", "type": "CPT"}], "standard_charges": [{"minimum": 1942.0, "maximum": 3136.0, "discounted_cash": 1606.66, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], 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"standard_charge_dollar": 36449.22, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 23168.78, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 18841.43, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 23168.78, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 30179.79, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC", "code_information": [{"code": "923", "type": "MS-DRG"}], "standard_charges": [{"minimum": 10921.1, "maximum": 21127.13, "discounted_cash": 7401.25, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 21127.13, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 13429.37, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 10921.1, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 13429.37, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 17493.17, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC", "code_information": [{"code": "699", "type": "MS-DRG"}], "standard_charges": [{"minimum": 11022.6, "maximum": 21323.49, "discounted_cash": 7470.04, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 21323.49, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 13554.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 11022.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 13554.18, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 17655.76, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC", "code_information": [{"code": "698", "type": "MS-DRG"}], "standard_charges": [{"minimum": 17864.21, "maximum": 34558.76, "discounted_cash": 12106.62, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 34558.76, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 21967.12, "methodology": "case rate"}, {"payer_name": 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7648.22, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 9404.81, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 12250.76, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC", "code_information": [{"code": "674", "type": "MS-DRG"}], "standard_charges": [{"minimum": 25723.0, "maximum": 49761.78, "discounted_cash": 17432.53, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 49761.78, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 31630.85, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 25723.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 31630.85, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 41202.53, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC", "code_information": [{"code": "673", "type": "MS-DRG"}], "standard_charges": [{"minimum": 39931.0, "maximum": 77247.52, "discounted_cash": 27061.34, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 77247.52, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 49102.04, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 39931.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 49102.04, "methodology": 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CC/MCC", "code_information": [{"code": "272", "type": "MS-DRG"}], "standard_charges": [{"minimum": 26341.72, "maximum": 50958.72, "discounted_cash": 17851.85, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 50958.72, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 32391.68, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 26341.72, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 32391.68, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 42193.59, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC", "code_information": [{"code": "729", "type": "MS-DRG"}], 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"discounted_cash": 4548.76, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 12984.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 8253.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 6712.04, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 8253.6, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 10751.19, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER MALE REPRODUCTIVE SYSTEM O.R. 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"MS-DRG"}], "standard_charges": [{"minimum": 13989.89, "maximum": 27063.79, "discounted_cash": 9480.98, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 27063.79, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 17202.98, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 13989.89, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 17202.98, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 22408.7, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC", "code_information": [{"code": "964", "type": "MS-DRG"}], "standard_charges": [{"minimum": 16207.8, "maximum": 31354.39, "discounted_cash": 10984.06, "setting": "inpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 31354.39, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 19930.28, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 16207.8, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 19930.28, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 25961.3, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC", "code_information": [{"code": "963", "type": "MS-DRG"}], "standard_charges": [{"minimum": 29524.97, "maximum": 57116.79, "discounted_cash": 20009.14, "setting": "inpatient", "payers_information": 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"plan_name": "Non Options", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5243.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE DIGIT NERVE LESION", "code_information": [{"code": "64776", "type": "CPT"}], "standard_charges": [{"minimum": 2125.0, "maximum": 3136.0, "discounted_cash": 1913.36, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2151.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE FOREARM FOREIGN BODY", "code_information": [{"code": "25248", "type": "CPT"}], "standard_charges": [{"minimum": 1942.0, "maximum": 3136.0, "discounted_cash": 1592.71, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 1942.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 3136.0, "methodology": "case rate"}], "billing_class": 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14751.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 13020.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 14751.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 19216.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE SPINE FIXATION DEVICE", "code_information": [{"code": "22852", "type": "CPT"}], "standard_charges": [{"minimum": 4618.0, "maximum": 7157.0, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 4618.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 5495.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 4848.0, 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"standard_charge_dollar": 5495.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 7157.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE SPINE LAMINA 1/2 LMBR", "code_information": [{"code": "63005", "type": "CPT"}], "standard_charges": [{"minimum": 4848.0, "maximum": 7299.0, "discounted_cash": 7089.53, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 7299.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 5495.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 4848.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 5495.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 7157.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE SYMPATHETIC NERVES", "code_information": [{"code": "64821", "type": "CPT"}], "standard_charges": [{"minimum": 2890.0, "maximum": 5243.0, "discounted_cash": 3207.64, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2890.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 3554.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5243.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE TENDON SHEATH LESION", "code_information": [{"code": "26160", "type": "CPT"}], "standard_charges": [{"minimum": 1209.0, "maximum": 2151.0, "discounted_cash": 1592.71, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2151.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REMOVE VERT BODY DCMPRN CRVL", "code_information": [{"code": "63081", "type": "CPT"}], 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{"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5243.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REPAIR ELBOW PERC", "code_information": [{"code": "24357", "type": "CPT"}], "standard_charges": [{"minimum": 2125.0, "maximum": 6115.0, "discounted_cash": 3207.64, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 6115.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 2125.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 2409.0, "methodology": "case rate"}, 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1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 1209.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 1370.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 1786.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REPAIR NONUNION HAND", "code_information": [{"code": "26546", "type": "CPT"}], "standard_charges": [{"minimum": 2890.0, "maximum": 5243.0, "discounted_cash": 7089.53, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2890.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 3554.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5243.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REPAIR OF ACHILLES TENDON", "code_information": [{"code": "27654", "type": "CPT"}], "standard_charges": [{"minimum": 2151.0, "maximum": 5688.0, "discounted_cash": 7089.53, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2151.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4366.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 3851.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", 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{"description": "REPAIR OF DIGIT NERVE", "code_information": [{"code": "64831", "type": "CPT"}], "standard_charges": [{"minimum": 2890.0, "maximum": 5243.0, "discounted_cash": 1913.36, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2890.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 3554.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 4025.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5243.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REPAIR OF FOOT TENDON", "code_information": [{"code": "28208", "type": "CPT"}], "standard_charges": 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{"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4366.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Navigate", "standard_charge_dollar": 3851.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Non Options", "standard_charge_dollar": 4366.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Options", "standard_charge_dollar": 5688.0, "methodology": "case rate"}], "billing_class": "facility"}]}, {"description": "REPAIR OF HAND OR FOOT NERVE", "code_information": [{"code": "64835", "type": "CPT"}], "standard_charges": [{"minimum": 2151.0, "maximum": 5688.0, "discounted_cash": 6601.36, "setting": "outpatient", "payers_information": [{"payer_name": "CIGNA", "plan_name": "All Plans", "standard_charge_dollar": 2151.0, "methodology": "case rate"}, {"payer_name": "United Healthcare", "plan_name": "Exchange", "standard_charge_dollar": 4366.0, "methodology": "case 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